Gemma Newman, MD On Optimizing Hormone Health

Today’s episode explores nutrition, lifestyle and overall well-being with a particular focus on hormone health – particularly (but not exclusively) women’s hormone health, aging, and reproductive care – with Gemma Newman., MD. A Senior Partner at a family medicine practice in the U. K. and author of ‘The Plant Power Doctor’, Gemma is a graduate of the University of Wales College of Medicine with expertise in a variety of specialities, including elder care, endocrinology, pediatrics, obstetrics and gynecology, psychiatry, general surgery, and urology. Today’s episode is also viewable on YouTube: https://www.youtube.com/watch?v=5S3UzS5YhcA To read more about today’s episode and review the show notes, visit: https://bit.ly/richroll678 To pick up Rich’s latest book Voicing Change: Vol. II, visit: https://www.richroll.com/voicing-change-ii/ Final Note: As a compendium to this conversation, Gemma created an impressively thorough document detailing all scientific references for this episode and many other helpful, additional resources. I strongly encourage you to download this free document HERE. Peace + Plants, Rich Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Rich Roll?

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• 0:44Rich Roll?

  It's kind of an amazing thing. For listeners of the show, all you special people, we're offering an exclusive $20 off an annual subscription right now. To get it, go to meals.richroll.com, take your quick personalization quiz, and enter promo code RICHROLL20 at checkout.

• 1:05Gemma Newman?

  My general position is I just want people to eat more plants. I think that, from what I've seen, the more plants, the better. And we see that in the data as well. The more plants we eat, the better. So it doesn't have to be plant-exclusive, but plant-predominant is definitely important for overall health. The way I see it, based on the research, is that the plant-race diet is abundant in nutrients. As long as you're choosing a large variety of fruits, veggies, whole grains, beans, nuts, seeds, tofu, tempeh, all of those incredible ingredients, you're gonna get everything that you need. But again, I think the health benefits that I've seen in my patients in the short term

• 1:47Gemma Newman?

  and the long term, and what we see in the data as well, show us that a plant-rich, and even a plant-exclusive diet, is brilliantly healthy. The bottom line is that plants are always good in terms of hormone regulation, and they can help to foster the microbiome that could potentially then also use other parts of plants to then benefit us.

• 2:19Rich Roll?

  The Rich Roll Podcast. Greetings, Internet. Welcome to the podcast. Today, we are back talking diet, nutrition, and overall well-being with an additional focus on hormone health, particularly, but not exclusively, on women's hormone health. And we're going to do it with Dr. Gemma Newman. Gemma is a graduate of the University of Wales College of Medicine. She has expertise in a wide variety of specialties, including elder care, endocrinology, pediatrics, obstetrics, and gynecology, psychiatry, general surgery, and urology, and serves as a senior

• 3:00Rich Roll?

  partner at a family medicine practice in the UK. She is also the author of The Plant-Powered Doctor: A Primer on the Power of Plant-Based Nutrition to Prevent and Reverse Many Common Chronic Illnesses, From Diabetes and Heart Disease to Obesity, and the Science That Explains Why It Works. More on Gemma and the conversation to come in a bit, but first. Okay, Dr. Newman. So Gemma first appeared on the show almost exactly three years ago. Our RP 449 was quite a popular episode, in case you missed it.

• 3:44Rich Roll?

  And today, because over the years, this show has already devoted literally dozens of episodes to the general relationship between food and chronic disease, I thought it would be interesting and wise to get specific on a topic that I have yet to explore in depth, which is hormonal health, specifically, women's hormonal health, and how this differs from general health advice, and the role that nutrition plays in impacting this important component of well-being. However, this one is not just for the women out there. We cover a variety of other areas applicable to all. It's worth pointing out that I learned quite a bit from this conversation, and I think

• 4:28Rich Roll?

  better understanding the general role that nutrition and lifestyle habits play in relation to hormone health is important, of course, for everybody. So, let's do it. This is me and Dr. Gemma Newman.

• 4:45Rich Roll?

  We're here, we're doing it.

• 4:47Gemma Newman?

  Yeah.

• 4:47Rich Roll?

  It took a minute, didn't it?

• 4:49Gemma Newman?

  It did.

• 4:49Rich Roll?

  You were supposed to come something like six months ago?

• 4:53Gemma Newman?

  Yeah, but then...

• 4:55Rich Roll?

  Richard got COVID.

• 4:56Gemma Newman?

  Yeah.

• 4:56Rich Roll?

  Yeah. So that got delayed and then I wasn't sure if you were ever gonna make it out, but here you are. I'm so delighted to sit with you today.

• 5:04Gemma Newman?

  I'm delighted to be here, I really am. I haven't been to LA in nearly 20 years.

• 5:09Rich Roll?

  Hmm.

• 5:09Gemma Newman?

  So it's been really cool.

• 5:11Rich Roll?

  Wow. Well, you picked a nice moment. We had some rain the other day, which was very unusual, but everything's uncharacteristically green. It must feel very, you know, much like, it feels like this is the Ireland time of year. It will quickly turn brown, but right now, it's pretty great.

• 5:26Gemma Newman?

  It is. I was, we were driving here this morning and I thought, wow, this looks so British. There's so much green.

• 5:33Rich Roll?

  I know.

• 5:34Gemma Newman?

  Really surprised.

• 5:34Rich Roll?

  Yeah, yeah, yeah. Well, we did it just for you, Gemma, to make you feel at home.

• 5:38Gemma Newman?

  I did.

• 5:40Rich Roll?

  And I was trying to remember the last time I saw you. Was it at the retreat or was it when I was in London? I can't remember. I mean, everything's a blur because of COVID.

• 5:48Gemma Newman?

  Yeah, I think the pandemic changes and warps time slightly.

• 5:51Rich Roll?

  For sure.

• 5:52Gemma Newman?

  Probably at the retreat, because I saw you in London between that and the last time I saw you.

• 5:56Rich Roll?

  I can't remember the order of events, the older I get. I don't remember what came before what, but anyway. You are here, lots of stuff to talk about. And because the first time you were on the show was many years ago, and also because it was recorded at the retreat in kind of a fireside format, I think it would be helpful and instructive to just sort of introduce yourself, your background a little bit, and this journey that you've been on that led you to being this advocate for the plant-based lifestyle.

• 6:27Gemma Newman?

  Okay. So I've been a doctor now for, oh, 18 years and I always knew I wanted to be a doctor. I felt that very strongly from a young age. But in my medical training, I think it's fair to say I didn't necessarily look after myself, a lot of late nights, a lot of studying. And then when I went into actually being a doctor, again, there was loads of night shifts and...

• 6:51Rich Roll?

  Does anyone look after themselves as a medical student or as a young doctor? I mean, there's really not a lot of room for that.

• 6:57Gemma Newman?

  Probably not.

• 6:58Rich Roll?

  That would be an unusual outlier case, I would think.

• 7:01Gemma Newman?

  You're right, I think it would be. And although... There is, I don't know what it's like in the US, but in the UK, you know, there is time for sports and stuff like that, sort of recreational stuff. But I didn't really partake of that. I was a real bookworm. And yeah, I partied as well, of course, but I think it's safe to say that my focus was not my health then.

• 7:24Rich Roll?

  Mm hmm.

• 7:24Gemma Newman?

  Like you say, most doctors at that stage don't really focus on health too much, which is ironic. But I felt like when I started work, something had to change because I was exhausted all the time. And I was falling asleep, I was coming home from late shifts. And I thought, I can't be doing this job for the rest of my life whilst feeling this way. So I knew something had to change. And at that time, I hadn't done a great deal of research. I just thought, well, I will calorie count, I will exercise, and I will cut the carbs because that's what the background hum was telling me to do. In med school, I learnt about nutritional deficiencies. I learnt pathology and anatomy and communication skills and lots of other things, but not

• 8:07Gemma Newman?

  a great deal about wellness nutrition. So, fast forward, I did brilliantly with that. I got my energy back, I felt great, I was proud of myself. Then I realised, to my dismay, that I still had risk factors for heart disease. I checked my lipid profiles and they were still raised. And I thought back then that there was nothing I could do about it, that it was just genetic, it was my destiny, and I'd have to cope with that later in life.

• 8:31Rich Roll?

  Mm hmm.

• 8:33Gemma Newman?

  And then, fast forward a few years, my husband, Richard, introduced me to your book, Finding Ultra.

• 8:38Rich Roll?

  Oh yeah, that's right, I forgot about that.

• 8:40Gemma Newman?

  Yeah, yeah. And he was running a marathon, he was doing initially quite badly, he was getting inflamed, injured. And then he decided, after reading your book and a few others, that he'd go plant-based. And that was my first introduction to plant-based living. I was sceptical, I know we talked about this before, but I watched closely with scepticism. He did brilliantly, his next marathon training run, he did like an hour and 10 minutes faster. That got me really interested. Not from an athletic point of view, I have done a couple of marathons myself, but I wouldn't call myself someone that's particularly athletic or focused on performance. For me, it was about my patience.

• 9:18Rich Roll?

  So, were you on board eating that way also in tandem with him? Or you were just observing him doing that and making mental notes?

• 9:27Gemma Newman?

  Yeah.

• 9:27Rich Roll?

  Skeptical mental notes?

• 9:29Gemma Newman?

  Yeah, I was observing. I didn't actually start.

• 9:32Rich Roll?

  So two different, two different types of, of meals happening in the household.

• 9:35Gemma Newman?

  Yeah, that's right. He was cooking for himself for a while and I was just watching and learning. And, you know, don't get me wrong, I had already read a little bit about the environmental side of plant-based living after he introduced me to your book and a couple of others. So I knew that there were some definite environmental benefits to plant-based nutrition, but I didn't have that kick myself. I just didn't feel like I could do it. It seemed too difficult. It seemed, oh, I don't know, a bit pious and not really me. You know, I had all these preconceived ideas about what it meant.

• 10:10Rich Roll?

  Right. This will mean that you're gonna end up carrying a picket sign.

• 10:14Gemma Newman?

  Yeah.

• 10:15Rich Roll?

  Walking around angry with Birkenstocks on.

• 10:18Gemma Newman?

  Well, yeah, no, I just, I think for me, I just thought, yeah, there were certain stereotypes that I had contributed, you know, sort of thought about what it meant to be plant-based, what it meant to be vegan. And I felt that that wasn't my identity at that time. So he did brilliantly. And I thought, well, if he can do so well, just running a marathon, what could it do for health? What could it do for my patients? I was thinking about heart disease, diabetes, cancer, our biggest killers in the Western world. Could it make a difference? And I realized through many years of reading that yes, it could.

• 10:56Gemma Newman?

  I decided to jump in. I did it myself. And I reaped the benefits. My cholesterol went down. I used to get a lot of knee aches as well when I was running all through my twenties. That stopped. So, you know, that's my own personal experience, but of course, it's not, that's not what I based my practice on. I have to read the research as well. But what I found was that it was really beneficial for my patients. And that's when I felt, you know, the magic really happened for me is when I could see with my own eyes the changes that my patients had experienced. And that fueled my passion. And I've been really passionate about it ever since.

• 11:36Rich Roll?

  So talk to me a little bit about the transition from you experiencing firsthand the benefits of this, your blood panels improving, et cetera, and moving towards then advising or advocating this approach with your patients, because those are two different things.

• 11:54Gemma Newman?

  Yeah, they are two different things. And I thought long and hard before I started to talk about this with my patients, because I knew that there would be a burden of evidence, if you like. Like, if I was going to be saying something to my patients, I needed to know that what I was saying was evidence-based. And so it took me a lot longer to have the courage, really, to start talking about it. But I think what many people don't realize is that a lot of the data exists, and it has existed for a long time. And it actually forms the basis of a lot of guidelines. It's just that we're perhaps not consciously aware of that. So the World Cancer Research Fund, for example, tells us that fruits and veggies and whole grains and beans are the cornerstone of a cancer-preventing diet. You know, the

• 12:38Gemma Newman?

  American College of Cardiology talks about plant-based diets for prevention of heart disease. We have the American College of Clinical Endocrinologists talk about how it's really helpful for preventing diabetes. And in the UK, we've got the Royal College of GPs, they've got their Green Impact Scheme. So there's actually a lot of approval, if you like, from large bodies that are involved with disease and nutrition. But I think still there is that reluctance in a lot of people to really sort of take it in.

• 13:11Rich Roll?

  Well, I think there's a couple of things. I mean, first of all, there's this notion that many medical practitioners have that lifestyle advice doesn't really land with the patient. Like, I can tell them to do it, but they're not going to do it. So I just need to give them these meds and tell them to maybe not eat so much, or, you know, some really general, basic stuff.

• 13:34Gemma Newman?

  Yeah.

• 13:35Rich Roll?

  But the reluctance is from this place of low adoption rates.

• 13:40Gemma Newman?

  Yeah, I think, yeah, you're right. And you have to believe that your patient is capable of change, I think, in order to start talking about it. And...

• 13:51Gemma Newman?

  That's hard because nobody likes to be told what to do. And doctors like telling people what to do. Because I think, you know, we've done a lot of training. We want to make things right. We want to help people. So we feel like if only they'd listen to us, then, you know, they would.

• 14:05Rich Roll?

  I think people want their doctor to tell them what to do, though.

• 14:08Gemma Newman?

  Do you think so?

• 14:09Rich Roll?

  I think people abdicate too much responsibility to their doctor's advice in general. I don't know what it's like in the UK, but in the United States, a general practitioner like yourself only has a few minutes with each patient. And so there's not enough time to go into great detail on all kinds of lifestyle advice. And there's no kind of follow up or accountability because those systems aren't in place. It's really just diagnose, prescribe, move on to the next person. And it's not the fault of the practitioner. It's just the way the system is set up.

• 14:41Gemma Newman?

  Yeah.

• 14:42Rich Roll?

  Do you feel that you, in your practice, like have a little bit more bandwidth to spend time with patients and follow up with them, et cetera? Because that piece is so important to all of this.

• 14:54Gemma Newman?

  It is important, and it's honestly the reason I went into medicine. And I think that I do have a great advantage if I think about it now. Because working in National Health Service, I have a patient list, nearly 3,000 patients. It's actually a really small practice. It's equivalent to one full-time doctor. So 3,000 people under my care. And we have only 10 minutes. So yes, you're right, we do have a very short amount of time. It's not a great deal of time to talk about lifestyle. However, we do have the ability to bring people back. We have that sense of continuity because it's free at the point of care. People don't have to pay anything to see me. And people can come and see me as often as they want to.

• 15:39Gemma Newman?

  They just need to book an appointment. So it's very, I'd say, certainly compared to the US, it's very easy to book an appointment. There's still a lot of complaints generally in society about how easy it is to get a doctor's appointment. But I think if we compare our healthcare system to the one here in the US, it's much easier. And I'm able to offer that accountability and also that support and that feeling of care that I think is really lacking perhaps when you're dealing with a system where it's very much drugs prescribed next, you know. So yeah, I do think I have a lot more freedom in that respect. And that's what I love about it. I love looking after my patients from cradle to grave. Again, it's slightly different where I work because we deal with everything.

• 16:23Gemma Newman?

  We deal with pediatric issues, obstetric issues, elderly care issues, everything and anything. People come to us first, whereas I think here they would more likely go to a specialist in their field.

• 16:37Rich Roll?

  It depends. Yeah, it depends. Well, yeah, if you have something acute, you're gonna find the specialist. But for the everyday stuff, I feel like a lot of that now is in these urgent care centers that are all over the place. So there isn't, at least from my experience, and I don't know what it's like for most people, but I don't have like a good relationship with a single GP that I go to see that kind of knows what's up with me. It's just if something flares up, I go to urgent care that that needs immediate attention. And I think we're seeing the disappearance of that patient doctor relationship because of the big HMOs and all that kind of thing.

• 17:14Gemma Newman?

  Yeah, I see that happening a little bit in the UK, but I think we still do have a lot more of that relationship. And I've got patients that have been with me. I've been at that practice now for 14 years. And I I've seen people grow up. I've seen families change, babies born.

• 17:30Rich Roll?

  Yeah, it's nice.

• 17:31Gemma Newman?

  People, yeah, passing away and sort of that whole cycle of life. I've seen it. I've been there for it. And I love it. That's why I became a doctor. So.

• 17:39Rich Roll?

  So you're gonna see a little bit of everything, but I suspect the low hanging fruit or what you see quite frequently are lifestyle ailments like, you know, certainly obesity, diabetes, and heart disease, right, which are kind of the bull's eye problems that a plant based, plant centric, plant predominant diet has shown to be quite beneficial in ameliorating or reducing the symptomology and the underlying causes.

• 18:10Gemma Newman?

  Absolutely. And you're right, that's that's the bread and butter really of what I see, mostly high blood pressure and diabetes, certainly in terms of chronic care.

• 18:20Gemma Newman?

  But you'll be surprised, there's a lot of other things that can also be affected by plant-based nutrition, which we may come on to, but I get a lot of people suffering from hormonal health issues, endometriosis, fibroids, period pains, menopausal issues, and believe it or not, those things as well can be improved potentially by eating more plants. And other issues, bowel disorders, I get a lot of people with gastrointestinal issues as well. So yeah, there is quite a broad range of things that can be affected. And it's lovely to be able to implement that. I don't necessarily manage to change the diet of everybody that comes in.

• 19:01Rich Roll?

  Sure.

• 19:02Gemma Newman?

  Because people come with their own ideas, their own concerns, their own expectations. But if they're open to suggestions, then yeah, it can be really special.

• 19:11Rich Roll?

  Is it a situation in which, now that you have this book out, The Plant-Powered Doctor, right? Like, oh, she's the plant-powered doctor. Like, if I go in there, she's going to tell me to, you know, eat this way. Like, I don't want to, I don't want to deal with that. I'm going to go to this other doctor.

• 19:23Gemma Newman?

  I don't think I've had that yet. You see, what I try and do with my patients is if they're interested, I'll refer them to my website, which is free. And there's loads of free resources on there. So I don't tend to sell too much.

• 19:35Rich Roll?

  But you're in the media, you're out there, people know who you are. Come on.

• 19:39Gemma Newman?

  You'd be surprised, in my town, I think, people don't, people don't tend to sign up to me because of that. But a few of my patients have caught on to the things that I'm doing online, and they follow me online. So I do have to be mindful of that.

• 19:51Rich Roll?

  Right.

• 19:52Gemma Newman?

  But yeah.

• 19:53Rich Roll?

  Yeah, balancing the, the public version of yourself and the daily practitioner version.

• 19:57Gemma Newman?

  Yeah, it's hard. Because, you know, I think people do have certain expectations of what their doctor should be, and how their doctor should be.

• 20:05Rich Roll?

  Right. I don't want you going on podcasts all the time. You're supposed to be, like, in the, in the office, like, looking at my labs.

• 20:11Gemma Newman?

  Exactly.

• 20:12Rich Roll?

  Right?

• 20:13Gemma Newman?

  Exactly. But no, I think I've had mostly, if not all, positive feedback, and people have been really inspired. And it's been lovely, actually. It's been a really nice addition to my practice, and one that I'll be forever grateful for. Because that's why I wrote the book. You know, it was, it was about kind of widening my circle of compassion, making sure that people who wouldn't have otherwise been on my list know about this information in a really accessible way. You know, there's, it's full color, and pictures, and clickable, and easy to access. And it's got the recipes too. So it's literally, I wanted to make it Dead simple.

• 20:49Rich Roll?

  Well, you achieved that. It's a beautiful book, so congrats.

• 20:53Gemma Newman?

  Thank you.

• 20:54Rich Roll?

  You mentioned hormones a couple of minutes ago, and I want to get into that. People who have been longtime listeners or viewers of this show know that I've had all manner of whole food, plant-based advocates on the program, medical professionals, including two recent appearances by our mutual friend, Simon Hill. And over the last nine years, I feel like I've covered most of the issues regarding this lifestyle and the role of nutrition and health generally, but one area that I admit to not having covered with any particular focus or intensity is women's health specifically, how this differs from general health advice and the role of food and hormones. So how do we find our way into this topic?

• 21:38Rich Roll?

  I mean, maybe start with some thoughts about, when you say women's health, like, what does that mean? How is that different from just human health in general? And we can get more focus from there.

• 21:48Gemma Newman?

  Yeah, so I did do extra qualifications in obstetrics and gynecology, OB-GYN, you'd call that here, and family planning as part of sort of my work as a doctor. So for a while, I worked in family planning as well. And I think it's not that women's health is over and above different in terms of nutrition to men's health, but that there are various considerations that we would have physically that men don't have. Now, obviously, the most common thing would be the fact that we have periods, and we are kind of bound by that sort of natural cycle from the age of puberty to the age of menopause.

• 22:33Gemma Newman?

  Menopause itself is a huge life transition, which doesn't occur in the same way with men, I think, because primarily because there's less of a fluctuation and a sort of... Um. Steep decline in hormones relevant to men's health.

• 22:46Rich Roll?

  It's more of a gradual decline as opposed to a precipitous one.

• 22:49Gemma Newman?

  Exactly. It's much more gradual. And I think that helps to ameliorate symptoms. Whereas for women, going through perimenopause, um, up to menopause, then you can actually have wild fluctuations of estrogen. It can go way up, it can go way down. And that's really one of the main things that's sort of responsible for a lot of the symptoms that women will get around the perimenopause, which we can, I suppose, define. Um. But, you know, hormones affect men too, obviously. They affect everybody. There's actually over fifty different hormones and they have to work together in synergy in order for us to perform at our best. And it affects every aspect of our lives, not just puberty, menopause, periods, fertility, but everything, mood, energy,

• 23:34Gemma Newman?

  um, our skin, um, sperm counts, um, all sorts of things. So it's actually integral to all humans, but I'd say for women, there are a lot more considerations, especially around, um, yeah, the fact that we, uh, carry children, um, and that we have periods and that we have to go through menopause, which are very distinct life phases that do require extra thought and attention, I think.

• 23:59Rich Roll?

  Mm hmm. And so what is the role that nutrition can play in this? And also lifestyle habits?

• 24:06Gemma Newman?

  So if we talk first about, um, periods perhaps, because that's probably one of the main things that, uh, women will focus on from around about the age of eleven or twelve. Um, the quality of your periods can change based on the nutrition that you have. So periods are starting earlier, um, which I think is an interesting thing. Um, I don't think that's just because of extra nutrition. Um, I think there are also other factors at play, um, with regard to, um, environmental pollutants and things like that. I think there's a lot of reasons why, uh, girls are starting their periods earlier. And that's really significant because essentially that means that our, our growth is kind of done.

• 24:50Gemma Newman?

  Um, we don't tend to get much taller after we start our periods. Um, and I think. If you go through puberty and start your periods too early, it can put you at increased risk of actually things like heart disease at a younger age.

• 25:04Rich Roll?

  I've never heard that.

• 25:05Gemma Newman?

  Yeah, which is a really interesting thing. And I think there's just a lot of extra hormone exposures in our environment that we haven't been able to consider before, so.

• 25:14Rich Roll?

  Meaning like environmental toxins, toxins in skincare products, et cetera, in our foods that are dysregulating our natural hormonal cycles.

• 25:25Gemma Newman?

  Yeah, exactly. And things that mimic estrogens in our body, plastics, for example, phthalates, BPA, they have hormone-mimicking effects, which I think do affect things like fertility in men's sperm counts, but also potentially also affect when young girls and women start their periods. So, yeah, there's a lot to consider now that we haven't really considered in the past because they didn't exist. But I think in terms of practical things that people can do, increased fibre is so important. The main reason being that if you're constipated, you're actually potentially recycling unwanted hormones through the body.

• 26:06Gemma Newman?

  Hormones that you would have otherwise got rid of, you're actually reabsorbing. So trying to make sure that young girls and, well, children and everybody in general doesn't get constipated is quite a good way of reducing our excess hormone exposure. I think it's important to mention that, you know, our fat cells in our body are also hormonally active. They can produce estrogen. So if we have more of those, then we also have more exposures to estrogen as a result of that, which can affect men as well as women. But I think that that's a really important thing that, again, is not necessarily talked about much, the fact that our fat is also hormonally active too.

• 26:49Gemma Newman?

  And, yeah, so I think fibre is a really important thing. It reduces our hormone exposures, it helps us to produce short-chain fatty acids, which is also great for helping our hormone regulation, feeding our gut microbiome, which is important as well for hormone regulation, which is also important for our immune system, which affects our hormone regulation. So all these things are linked.

• 27:11Rich Roll?

  Wait, you're saying it's all related?

• 27:12Gemma Newman?

  I am.

• 27:15Gemma Newman?

  Yeah.

• 27:15Rich Roll?

  I had Dr. B in here the other day, going deep on fiber once again.

• 27:20Gemma Newman?

  Yeah, of course.

• 27:21Rich Roll?

  Yeah, and his whole thing about, you know, eating 30 different plants, you know, setting that as a goal and the importance of fiber for any number of things and just how critical it is in this conversation, it tends to get lost. We focus on macronutrients or protein or, you know, our omega-3s, all of which are important, of course, but most people are fiber deficient. Like, whereas, again, back to the low-hanging fruit, like, what is the quickest, easiest change that you could make that could have the biggest impact? And increasing the fiber in your diet seems to have just a multiplicity of downstream health benefits.

• 28:00Gemma Newman?

  It does. And there was a study, I think it was actually led by Dr. Neil Bernard, looking at how this could affect people and their periods. And they had a two-month cohort of women. Half were on a healthy, plant-based diet, the other half were a control group. And they wanted to see, could it affect their periods? And what they discovered was that it did make a statistically significant difference in the length and the heaviness of the women's periods. And also-

• 28:31Rich Roll?

  Just by increasing fiber?

• 28:32Gemma Newman?

  Yep, just by increasing fiber. And it also showed a raised SHBG, sex hormone binding globulin, which is an important protein that essentially holds on to hormones until we need them. It's kind of like a storage molecule, if you like. And what's interesting is it was able to increase that for the women who were consuming a healthy, plant-based diet, which is important because that can help regulate their unwanted hormone exposure as well.

• 29:00Rich Roll?

  And is that a function of just an increase in plant foods and, by definition, an increase in fiber? Or is there an aspect of that that has to do with the removal of the meat and dairy products?

• 29:14Gemma Newman?

  It could be a bit of both. So this is postulation-based. So that study didn't say specifically why, but we know that fiber is so crucial for reducing recycling of hormones, as I mentioned, but also- Meat and dairy does have a role to play with regard to hormone exposure itself. So, you know, when we consume dairy, we're consuming the milk from a cow who's been pregnant and obviously is lactating, which has extra hormones, bio equivalent hormones to human hormones. But also in the meat that we eat, there is some hormonal exposure there as well. But also, interestingly, I think, is that meat is one of the main ways that we get

• 29:56Gemma Newman?

  potential for microplastics exposures, which are also affecting our hormones. I think in the UK, phthalates are highest in fish. In the US, phthalates are highest in chicken. And there is some data to show that there was an association between increasing meat consumption and increasing endometriosis symptoms.

• 30:16Rich Roll?

  So maybe, maybe define phthalates and then endometriosis. I'm not sure I even know what endometriosis is.

• 30:23Gemma Newman?

  Okay, so let's do a little backtrack. Endometriosis is a condition that could affect up to about 10% of women. And it takes many years often to diagnose because the women who are suffering from endometriosis just think that perhaps they've got really heavy periods. But it's so much more than that. So what it is, is where the womb lining tissue, which normally just grows in the lining of the womb and is shed once a month with your period, starts to grow in other parts of the body. We don't know why this happens. It predominantly happens in the pelvis, so you get that tissue that grows in the lining of the womb in other parts of the pelvis, often sticking perhaps to bowel or to the bladder.

• 31:08Gemma Newman?

  But interestingly, you can get endometrial deposits anywhere, even in the brain, very rarely, or in the lungs. And the problem is, when you have your monthly bleed, those cells will also bleed. And when they do, they cause irritation and inflammation.

• 31:24Rich Roll?

  So no matter where they are in the body, they start to bleed?

• 31:27Gemma Newman?

  Yeah. They will bleed.

• 31:29Rich Roll?

  And it can cross the blood brain barrier.

• 31:31Gemma Newman?

  Yeah, very rare. But yeah, it's mostly around the pelvis or, you know, deposits perhaps on the outside of the womb. But the problem is that inflammation and irritation then causes a lot of pain. And it can cause parts of like the bladder or the bowel to stick together. It can affect fertility. It can cause painful sex. It's, you know, it's a really sort of far reaching condition. And, you know, if women are suffering from horrendous period pains, you know, nausea, vomiting, have to take days off work, painful sex, problems getting pregnant, this is not normal. And they have to go to the doctors because many people will think, oh, it's just my period.

• 32:13Gemma Newman?

  But interestingly, you know, periods, periods can be really painful. More painful than a heart attack, actually, in some, some research tells us that they, that the pain of having a period because, it's because of the prostaglandins that are produced by those womb lining cells. So, you know, when you're having a bleed, these prostaglandins that, that cause contraction of the, of the womb, that's what causes the pain and, and the, you know, the, the issue, the cramping, those sort of feelings of nausea, if it gets, if the prostaglandins get into the bloodstream, that's what causes you to have things like diarrhea and vomiting, nausea. It's, it can get really bad. And I think, you know, women don't always sort of know how to advocate for themselves.

• 32:58Gemma Newman?

  You know, people think, oh, it's just her period. Well, actually, for a lot of women, they really do suffer. And especially when you have endometriosis, which is a whole other condition related to your periods, but causing so many more complications. So.

• 33:12Rich Roll?

  So it goes, it goes undiagnosed often because people just think you're having a severe period episode or you're ignored and just considered to be normal?

• 33:24Gemma Newman?

  Yeah. So, you know, either doctors will think, oh, she's just having a heavy period. I'll give her some painkillers. Or she'll think, oh, I'm just having a heavy period. I'll just have to wait a few days later, it'll be okay. But for some women. You know, it's completely life-changing and it can have a huge impact. And as I say, up to 10% of women have this condition.

• 33:43Rich Roll?

  And is there a test for it? And then, once it's diagnosed, how is it treated?

• 33:48Gemma Newman?

  So, this is why it's hard to diagnose, because the main way of doing so is through a laparoscopy. So you have to have an operation, essentially, to see those deposits, which are usually in the pelvis.

• 33:59Rich Roll?

  Right, which no one's gonna do unless it's so severe.

• 34:01Gemma Newman?

  Exactly. So people will try and, you know, muddle through. They might take some painkillers and, you know, hope for the best. But actually, it's really important to get that diagnosis, because, once you have a diagnosis, um, one of the main ways of treating it is, is, um, to actually kind of blast those little deposits, burn them off, and that can help to improve fertility and pain. But, I would love for women to know that diet and lifestyle can have an effect on endometriosis as well, a positive effect.

• 34:30Rich Roll?

  Mm-hmm.

• 34:30Gemma Newman?

  And having a healthy, plant-rich diet could improve symptoms greatly. Uh, so, yeah, I, I would love for, if, if there's one message for this part of the podcast, it would be for women who have endometriosis to know that hopefully, if they have a more plant-based diet, they could see some improvement in their symptoms.

• 34:49Rich Roll?

  Hmm, interesting. But they don't quite know what causes it, and there isn't any kind of, like, simplistic cure?

• 34:57Gemma Newman?

  No, there's no simplistic cure. Um, but, I, I suspect that our extra hormone exposures in the modern world play a part. Um, just because, as I said, there's an association there between, uh, the consumption of certain animal products and, uh, the development of further endometrial deposits. And, we don't yet know. I'd love for there to be more research. It's the same with fibroids. I would love for there to be more research into fibroids.

• 35:28Rich Roll?

  Well, let's talk about that. Define what fibroids are.

• 35:31Gemma Newman?

  Okay. So fibroids are essentially growths in the womb and they are estrogen dependent. So much like endometriosis, which is in a way fueled by estrogen exposures, so is the development of fibroids. And you can get extra painful periods again with fibroids without realising it. So you'd be thinking, oh, I've just got a heavy period, but actually the reason that you've got it on this occasion is because your fibroid mass, the lump, is pushing against the womb lining, which is causing it to increase in the surface area, then it bleeds more, then the period is heavier. So not all fibroid lumps push into the womb lining.

• 36:16Gemma Newman?

  Sometimes they can grow on the outside of the womb or in the middle of the womb. But for the ones that push onto the womb lining, they cause extra heavy bleeds. And, you know, if the fibroids get big, then they also have just a mass effect in the pelvis, which can, you know, affect, you know, the way that you pee or the way that you're able to pass motions. So it can have other downstream effects as well. And again, I would really love to see more research into the causation and amelioration of fibroids, but suffice to say, in terms of lifestyle, there are some things that we've seen could be associated with it. Again, we come back to the meat consumption, that can have an impact on the growth of fibroids, perhaps because of the extra estrogens or plastics that we're exposed to.

• 37:01Gemma Newman?

  Alcohol is another one that has been associated with fibroids. Physical exercise has been something that's potentially been associated with less severe fibroids, but we just have association data really, so I'd like to see more of it.

• 37:17Rich Roll?

  And is there a test to know whether you have fibroids or if you have them, you just know it?

• 37:22Gemma Newman?

  You don't just know it unfortunately, but you can get a scan. It's much easier to diagnose fibroids because you can just, you can arrange for an ultrasound scan and you'd be able to see those lumps there. Sometimes with a scan, you can see what could be endometrial deposits. So if you have an unusual appearance to your ovaries. It could be something called a chocolate cyst because you get sort of dried old blood then on the ovary itself, which looks like, you know, a sort of a dark cyst. And you can sometimes see those.

• 37:53Rich Roll?

  Because those cells have bled during the period.

• 37:56Gemma Newman?

  Yeah, exactly, exactly. So you can kind of get a hint of endometriosis through a physical exam. If your primary care physician or your OB GYN has done an internal exam, you can sometimes get a feel for whether there's endometriosis there based on whether the womb or the ovaries feel fixed when you do an internal exam. And you can, again, maybe get a hint of it with an ultrasound, but the only way of truly diagnosing endometriosis is with a laparoscopy. But fibroids is much easier because you only really need a scan.

• 38:30Rich Roll?

  And the appropriate lifestyle interventions for fibroids look like what?

• 38:35Gemma Newman?

  Well, I'd say really focus on whole foods, healthy, plant-rich diet, number one. You'll be increasing your fibre, so as I said before, reducing your hormone exposure from your own body. You'll be hopefully helping yourself to potentially reduce any excess weight. And you'd be avoiding xenoestrogens from plastics exposures as well. So that would be the main thing, I'd say. Exercise is important. Interestingly, there's some research to show that certain things are great for reducing the pain of periods, which can affect endometriosis and fibroids. So ginger and turmeric have been shown in a couple of studies to be really helpful

• 39:19Gemma Newman?

  in reducing the amount of prostaglandins that are being produced at the lining of the womb. So, I mean, essentially, if we kind of figure out, this is why oral contraception can help periods, actually, because oral contraceptive pills reduce the amount of endometrial lining cells that are produced, which then reduces the prostaglandins, which is what causes the pain and the cramping. So. Yeah, so contraceptive pills can help with the pain. Anti-inflammatory painkillers can help with the pain for the same reason. They reduce the prostaglandins. But if we wanted to go sort of down a sort of a lifestyle route, then ginger and turmeric have been shown in studies

• 40:03Gemma Newman?

  to have the same benefits as anti-inflammatory painkillers for reducing period pains.

• 40:08Rich Roll?

  So on some level, this is a disease of inflammation or a disease that's exacerbated by exposing the body to inflammatory foods and environmental factors, right? So it would follow logically then that a diet that is anti-inflammatory in nature, I mean, it's good for everything, right? Would be particularly good at ameliorating the symptoms of these conditions.

• 40:37Gemma Newman?

  Yes, I think so. And if we look at other hormonally driven things, so not just endometriosis and fibroids, but also polycystic ovaries. Again, it's another condition that affects fertility, affects our periods, but can also be improved using lifestyle. Again, it's not something that tends to come up in these kinds of conversations, but PCOS, polycystic ovarian syndrome, is very much like diabetes in that it's driven by insulin resistance. And insulin resistance can be improved by using whole plant foods, eating a much more whole food, plant-based diet. And so, yeah, that's another condition that could potentially also be improved using lifestyle

• 41:22Gemma Newman?

  and have long-reaching benefits.

• 41:24Rich Roll?

  Sure. So increasing your fiber, turmeric, ginger, what are some of the other anti-inflammatory foods that top your list?

• 41:34Gemma Newman?

  Well, we've got to go for berries, fruits, vegetables, nuts and seeds, tofu, tempeh. I think soybeans have a terrible reputation still, unfortunately, but they are really good for hormone regulation because not only do they contain all essential amino acids, but they also, they contain a special kind of phytoestrogen, which is actually beneficial. So. It's actually more of a modulator rather than something that is an active pusher of estrogen, if you like.

• 42:11Rich Roll?

  Right, so let's like really underscore that because I think what happens is people hear soy, they think estrogen. You spoke earlier about dysregulated estrogen causing these problems. So without further inquiry, it would appear that eating something like soy with these estrogen compounds would be not a good thing, right? So like, I want you to be like really clear about soy, estrogens, phytoestrogens, the differences.

• 42:41Gemma Newman?

  Okay, so soy contains phytoestrogens or estrogens, but it's actually what we call a selective estrogen receptor modulator.

• 42:51Rich Roll?

  Right, and if you're British, you say estrogen.

• 42:53Gemma Newman?

  Yes, sorry.

• 42:54Rich Roll?

  Keep going, sorry to interrupt you.

• 42:55Gemma Newman?

  My estrogen. So it's selective in its action. So what it does is if you are wanting to reduce your risk of breast cancer, it's really great for that because it blocks the receptors that are responsible for, you know, breast cancer. If you want to improve your bone health, it's actually really good for that because it's more likely to selectively bind to the receptors that are in the bone area of the body. So it has selective effects which are actually beneficial in terms of our hormone exposures. It stops us from being exposed to bioequivalent hormones and instead blocks those. So it's good for reducing risk of breast cancer, especially if you start to eat soy products young in life.

• 43:38Gemma Newman?

  So for, you know, young girls, teenagers, young women, there is some evidence to show that if you have soy products in childhood and adolescence, it's much more likely to reduce your risk of breast cancer later in life.

• 43:51Rich Roll?

  But if you're a dude or a mate? And you get on the soy early, you become a soy boy and develop man boobs.

• 44:00Gemma Newman?

  Well, you're probably more likely to develop man boobs if you drink actual cow's milk, if you think about it, because that's a bioequivalent estrogen. But in actual fact, there is data to show that soy can potentially reduce the risk of prostate cancer. So you don't need to worry too much about soy. Or in fact, you don't need to worry at all about soy.

• 44:17Rich Roll?

  Is there a difference between soy or tofu versus like tempeh or a fermented soy? Like, I've always understood that a fermented version is better.

• 44:31Gemma Newman?

  Yeah, I think there are different qualities, I suppose. Interestingly, soy products have been shown to be beneficial for flushes, sort of period flushes, vasomotor symptoms in women. So, yeah, but in sort of Japanese populations, they don't really have the same amount of flushing. And it's thought to be because they have a lot of fermented soy products, sort of miso and tempeh and edamame beans. And not that that's fermented, but it's a more natural form of soy.

• 45:05Rich Roll?

  Yeah.

• 45:06Gemma Newman?

  But yeah, I think if you go for minimally processed sort of tofu, tempeh, edamame beans, miso soup, that kind of thing, you're going to have perhaps even better benefits, but yeah.

• 45:19Rich Roll?

  What about natto? Have you had natto?

• 45:21Gemma Newman?

  I've not had it, but I've heard it's disgusting.

• 45:23Rich Roll?

  I've heard that as well. It's atop the list, though, of like the most nutritious fermented soy product. And it's an acquired taste that they enjoy in Japan, but is not necessarily readily available in the West.

• 45:35Gemma Newman?

  No, I mean, yeah, maybe I'll try it one day, but I haven't tried it yet.

• 45:39Rich Roll?

  It's it's sort of the soy version of durian, right?

• 45:44Gemma Newman?

  But actually, durian's delicious.

• 45:46Rich Roll?

  Yeah, but it's an acquired taste. I mean, durian's a hardcore thing.

• 45:50Gemma Newman?

  Yeah.

• 45:50Rich Roll?

  I mean, the people that love it really love it.

• 45:52Gemma Newman?

  Yeah. But it smells quite strong, though, doesn't it?

• 45:55Rich Roll?

  For sure, for sure.

• 45:56Gemma Newman?

  But I actually wanted to say, before we get off the topic, that interestingly, going back to the gut health MD and his passion for the gut microbiome.

• 46:06Gemma Newman?

  The effect of soy on flushes and things like that can be affected by our microbiome or estrabolome. So some people, unless we have the gut bugs to sort of process the genocine from the isoflavone in soy, we may not necessarily get the same flushing benefits, which is why it's great then to have an overall plant-rich diet. Because what you're doing there is you're promoting the kind of gut bugs which would then hopefully be able to metabolize the components of soy that benefit us in terms of vasomotor flushing.

• 46:39Rich Roll?

  Right, so if you have some form of dysbiosis, that could be a causal factor in a dysregulated, not a dysregulated hormonal state and also a dysregulated period, right? Or some kind of period issue.

• 46:54Gemma Newman?

  Yeah, potentially. So yeah, I'd say the bottom line is that plants are always good in terms of hormone regulation, and they can help to foster the microbiome that could potentially then also use other parts of plants to then benefit us.

• 47:09Rich Roll?

  Hmm. How do you think about, when you're advocating a plant-based lifestyle, how do you think about the difference between a plant-exclusive diet versus a plant-predominant diet? As somebody who's seeing a lot of patients, and for many, I suspect this is like a new idea, how do you communicate around that and what is your kind of general position on that?

• 47:31Gemma Newman?

  Yeah, my general position is I just want people to eat more plants. And I don't tell my patients to go vegan, because I think we do have a lot of data that you can have a very healthy, plant-rich diet without necessarily going 100% vegan. I am somebody that identifies as vegan, but it's not something that I would say my patients have to do. I think that, from what I've seen, the more plants, the better. And we see that in the data as well, the more plants we eat, the better. So it doesn't have to be plant-exclusive. But plant predominant is definitely important for overall health. And I just, you mentioned sort of low hanging fruit earlier. That's kind of how I feel about it right now.

• 48:14Gemma Newman?

  You know, only eight percent of what most of people in the Western world eat is fruits and veggies. You know, it's more than 50% processed foods. So if I can get people more on those fresh, whole plant foods and less on the processed foods, then that's a win. So yeah, that's how I tend to advocate for it at work with my patients. Because not everybody's going to feel 100% ready to just dive in.

• 48:36Rich Roll?

  Yeah.

• 48:37Gemma Newman?

  So, yeah.

• 48:38Rich Roll?

  Have you had any patients come to you who are on the carnivore diet?

• 48:42Gemma Newman?

  I haven't, no.

• 48:44Rich Roll?

  Is that a thing in the UK? Because it's like quite a thing here in the States.

• 48:47Gemma Newman?

  I know it's a big thing here and it's getting more popular in the UK. But you know what? If I'm honest, I've only really seen it in online and in wellness circles rather than in my actual patients. I think instinctively, most people feel that having a meat exclusive diet could cause long term issues. So.

• 49:08Rich Roll?

  How dare you?

• 49:08Gemma Newman?

  I'm sorry to say. No, but I think, yeah, it's not been something that I've actually experienced in my patients. But it's a tough one because in my practice, I never like to say to people that they're doing something that's wrong. Because we all have different paths to health. Having said that, it's really hard, it's really hard because, you know, people sometimes feel great on a carnivore diet to start with. You know, they may have got rid of a lot of health issues that they were having in the past. And for me, I think that probably comes down to a fairly strict exclusion diet. You're basically taking everything out, which is fine for short term, but it's not really something that you could consider long term health.

• 49:52Rich Roll?

  Yeah, that, that argument gets used against the plant based diet as well. Like, oh, you feel better when you went plant based because you just got off all the processed foods. But it's not sustainable and over time you're going to be nutrient, mineral and vitamin deficient.

• 50:06Gemma Newman?

  Yeah, it's a shame that people say that about plant based diets because the way, the way I see it based on the research is that. The plant-based diet is abundant in nutrients. As long as you're choosing a large variety of fruits, veggies, whole grains, beans, nuts, seeds, tofu, tempeh, all of those incredible ingredients, you're going to get everything that you need, except the B12. But again, I think the health benefits that I've seen in my patients in the short term and the long term, and what we see in the data as well, show us that a plant-rich and even a plant-exclusive diet is brilliantly healthy.

• 50:45Rich Roll?

  What about the argument, I'm sure you've seen this at least online, that plants are toxic, that they have toxins, that they've developed as natural defense mechanisms, and that makes them intolerable to the human body. Have you heard that one?

• 51:00Gemma Newman?

  I've heard that one online, again, not with my patients. I think it's, I think a lot of extreme ideas tend to come from online spaces, and perhaps, I don't know why that would be, but I think if we, if we look at the properties of plants, yes, they do have certain sort of phytonutrients that we benefit from, but the toxins idea, I think is actually something that is really damaging, because often it's those plant so-called toxins that provide us with really important factors for our own health, because our bodies can use them in ways that actually help us to support our microbiome and our immune systems. So I think that's the difference between perhaps mechanistic data and actually seeing

• 51:43Gemma Newman?

  what people do in real life and seeing what they eat in real life for longevity and health, which are two sometimes completely opposed ideas. When everything comes together, when mechanistic data and observational data and randomized control trials all come together pointing to one direction, we can feel a lot more confident. Whereas if we're just looking at a single trial or a mechanistic trial on an animal, for example, we're not going to really have the same picture.

• 52:10Rich Roll?

  Let's talk about menopause.

• 52:12Gemma Newman?

  Yeah.

• 52:12Rich Roll?

  So what is it? And what can women do who are experiencing it? Reduce the symptomology around it?

• 52:21Gemma Newman?

  I'm actually really glad to talk about menopause because I think it's something that many women feel that they can't talk about.

• 52:29Rich Roll?

  It's weird. It's like this weird, like it happens to every woman, right? But it's this sort of, not really shameful, but like something that, oh, we just don't talk about it.

• 52:38Gemma Newman?

  Yeah. And I try to think about where that comes from. I do think that we live in a patriarchal kind of society that really values women for the way that they look more than the way that they contribute to the world. And I think a lot of women feel that if they talk about menopause, that their significance in the world is diminished somehow, that their function to produce children is, is gone, therefore their worth is gone. That's, that's something that I've noticed a lot, certainly in my patients, but also in general society, that people feel really reluctant to speak up about it and quite

• 53:23Gemma Newman?

  low about it. Like it's, it's something that, that a lot of women feel that they've lost something about themselves. And I'd really like the conversation to change because I think that if we can have an empowering idea about what menopause can do, then it can hopefully help women to, to actually feel that they're even more contributing to the world in ways that they couldn't do before. You know, there's only very few mammals that, that have a menopause. This is really interesting. There's three mammals that experience menopause. Obviously, humans are one of them. Do you have any idea what the other ones could be?

• 53:59Rich Roll?

  Well, I would think it would be chimpanzees or apes.

• 54:03Gemma Newman?

  You'd think so.

• 54:04Rich Roll?

  Right.

• 54:04Gemma Newman?

  But actually, it's not.

• 54:06Rich Roll?

  Don't tell me it's dolphins.

• 54:08Gemma Newman?

  Nearly.

• 54:09Rich Roll?

  Really?

• 54:09Gemma Newman?

  Yeah. It's, yeah, it's orcas and pilot whales.

• 54:13Rich Roll?

  Wow.

• 54:13Gemma Newman?

  Orcas, pilot whales, and humans.

• 54:16Rich Roll?

  That's so bizarre. I would have just presumed that every mammal. Every female mammal experiences that.

• 54:23Gemma Newman?

  No, and this is significant because what it tells us, I believe, is that we have a very specific purpose past our reproductive years. You know, we have a very specific survival advantage in having a menopause, whereas every other mammal does not. And there's actually something called the grandmother hypothesis, which essentially tries to explore this. And the idea is that, you know, the reason that humans have menopause is because women in society have such value in making sure that we continue as a species. And we maybe look after younger children, we would bring families together, we would bring

• 55:03Gemma Newman?

  communities together. There's a very strong survival advantage to having women exist past their reproductive years. And I think that should be celebrated because it's something very special. So, yeah.

• 55:16Rich Roll?

  Right, the idea that evolution has prioritized this because when the village expands and there's more women around to caretake for the many young ones, then everybody benefits as a result.

• 55:28Gemma Newman?

  Everybody benefits, and there's a survival advantage.

• 55:31Rich Roll?

  But you would think that would be the case with chimpanzees and apes and all other manner of mammals as well.

• 55:36Gemma Newman?

  Yeah, you'd think so, but it's interesting because when you look at pilot whales and orcas, they have a very matriarchal society, don't they? They go around in matriarchal pods, and it's the grandmother that makes sure that the mother and the babies are all together and protected. So...

• 55:51Rich Roll?

  Right, so we're off the rails here being a patriarchal society, right?

• 55:54Gemma Newman?

  We're completely off.

• 55:55Rich Roll?

  We are evolutionarily meant to be a matriarchal society?

• 55:59Gemma Newman?

  Yes.

• 56:00Rich Roll?

  Okay.

• 56:00Gemma Newman?

  I think so. That's my hypothesis.

• 56:03Rich Roll?

  Yeah, interesting.

• 56:04Gemma Newman?

  Yeah.

• 56:05Rich Roll?

  So, this occurs in every woman at a certain age, and it can, you know, the symptoms range in severity.

• 56:15Gemma Newman?

  They do. And that's another interesting thing, is the symptoms can... Ranging severity based on where the woman lives in some, to some degree. So, you know, that I mentioned Japanese women and vasomotor flushes. I mean, that's one of the main symptoms for women, certainly in the US and the UK, is hot flushes or flashes.

• 56:35Rich Roll?

  Yeah.

• 56:36Gemma Newman?

  Whereas interestingly, Japanese women don't tend to experience that. There was some anthropology work done in two provinces of India that showed that menopause brought about increased quality of life in those women because they were able to achieve more status, they were able to spend more time with men, they had more of a say in the household over the sort of the sons and the wives and other younger children. So in actual fact, when there were sort of questionnaires to those women, they had an increased quality of life and far less menopausal symptoms than-

• 57:11Rich Roll?

  But what is the, I'm trying to understand what that's attributable to, the increase in quality of life.

• 57:17Gemma Newman?

  Yeah, I think that a lot of the symptoms of menopause can be dreadful, but also that the society in which we live, if it's more supportive to women going through menopause, can dramatically reduce the effect on our lives. So when you have a society that is supportive or where the woman is considered to be of value, wise, contributing, then it can be actually quite empowering and it can hopefully potentially lead to less in the way of symptoms. That's not to say that it's all psychological, no, there's some very physical and very real problems. But I think it's important to just be aware that in society and the way that we view

• 58:02Gemma Newman?

  women is really important because it can affect our long-term happiness, it can affect the way that we feel we can contribute to the world, and that can also affect the symptoms that we experience, much with any kind of medical or health condition.

• 58:14Rich Roll?

  That's fascinating.

• 58:15Gemma Newman?

  Yeah.

• 58:16Rich Roll?

  That the social environment and a supportive social environment can- Can have that kind of impact.

• 58:22Gemma Newman?

  Yeah, and it's true.

• 58:23Rich Roll?

  Or it seems to appear that that's the case.

• 58:24Gemma Newman?

  It seems to appear that way. And it's true for all sorts of things. There was a really interesting study that showed that people who had increased happiness scores, positivity, a good sense of humor, their longevity was increased even when they were living with chronic disease. So, you know, I think the importance of a supportive community shouldn't be underestimated, which is why opening up this kind of conversation is really important, so that men and women can understand how to support the third of women that are right now peri or, you know, post-menopausal. It's huge.

• 59:07Rich Roll?

  I mean, that dovetails into the Blue Zones discussion and the importance of connectivity and community and also, of course, like holistic health, like how we think about these things, which we can put a pin in, but sorry, I interrupted you. Continue.

• 59:19Gemma Newman?

  Yeah, no, well, I was just gonna sort of start talking about some of the symptoms, which, again, are not that well-known, apart from the flashing or the flushing, because women don't tend to talk about it too much.

• 59:30Rich Roll?

  I've been married to Julie for over 20 years, and I know about the occasional hot flashes, but beyond that, like, I'm probably like a lot of guys, like, I don't really know what's going on.

• 59:41Gemma Newman?

  Yeah, well, it's okay, but it's good that you can be more aware, and hopefully we can sort of expand on that now, and all the men who listen to your podcast can hopefully...

• 59:50Rich Roll?

  Right, I mean, I want to, yeah, this is about women's health, but it's also about, like, helping men understand these things, so that they can be more empathetic to their partners, if they're in partnership with women, and learning how to, like, communicate around it in a positive manner.

• 1:00:06Gemma Newman?

  It's true. In fact, I think that Rod Stewart said that if more men knew about menopause, there'd be far less divorces.

• 1:00:16Rich Roll?

  So do tell.

• 1:00:17Gemma Newman?

  So I will. So we've got the vasomotor flushes, which can be really debilitating for some women, where you just have this tremendous heat going through your body, top to bottom, sweat like crazy. It tends to happen a lot at night as well, but it can happen at any time of day. Vaginal atrophy is a big one, and it doesn't just mean that you have soreness or some sort of dryness there. It can actually be quite severe for some women. So vaginal atrophy occurs when your estrogen levels are going down, and it can cause painful sex and dryness, but also it can cause severe burning,

• 1:00:58Gemma Newman?

  itching, like it can hurt to sit down. If you had an apesiotomis scar when you were, from when you were giving birth, they can sort of come open, they can split and bleed. Like it can be a really severe problem that, again, is very little talked about, but can really impact the quality of life. Mood changes can be quite severe. Increased anxiety is very real. And many women will put it down to, oh, I'm just depressed. They may think that they need an antidepressant, but actually it could be that the hormone changes around menopause are responsible for some of those changes in mood. Body aches, this is a really interesting one. Many women don't realise that severe bone and muscle pain can be attributable

• 1:01:39Gemma Newman?

  to those hormonal changes. Up to 30% of women going through menopause get body aches, but they won't always attribute it to those changes in hormones, which is another big one. Dry skin, dry eyes. Some women only experience severe dry eyes, which can again be very debilitating. You know, having to use drops, not being able to see properly. It can actually really impact quality of life as well. Low libido, your sex drive can sometimes go down. Understandably, if you have vaginal atrophy, but sometimes there are other things attached to that as well with regard to identity and, you know, feelings of worth and attractiveness to your partner,

• 1:02:22Gemma Newman?

  that there's all sorts of other things that can sort of play a role there. So yeah, there's quite a lot of different symptoms. You are more likely to get constipated because there are estrogen receptors that are in the gut. So you have reduced gut motility, which then has an impact on, again, your hormone regulation. You, because of the lack of estrogen, your body tries to come back to balance. And so you get metabolic changes as well. In the Western world, about sixty five percent of women have obesity because of the way that the fat deposits more around sort of the centre of the body as a way of trying to compensate for the lower estrogen that's been produced by the ovaries. Because as we talked about earlier, fat cells can produce estrogen.

• 1:03:07Gemma Newman?

  So again, that these are things that a lot of women don't necessarily realise are related to those changes in hormones. Bone loss, so unfortunately, from about forty onwards, we'll lose about half a percent of our bone mineral density. But when you go through menopause, that drops precipitously. Many women will lose about twenty percent of their bone mineral density in the first five to seven years after menopause.

• 1:03:33Rich Roll?

  Wow.

• 1:03:33Gemma Newman?

  And that causes you increased risk of fractures.

• 1:03:35Rich Roll?

  Yeah, that's, that's very significant.

• 1:03:37Gemma Newman?

  Yeah, it's really significant. So I think that this is a public health issue. And I think that if more women knew that the time around menopause can be a time of empowerment, then they could actually potentially prevent further problems. So HRT or HRT is something that, again, we don't tend to talk much about, but is a really important.

• 1:04:02Rich Roll?

  Hormone replacement therapy.

• 1:04:03Gemma Newman?

  Hormone replacement therapy. It's a really important thing to open up a conversation around because it's one of the number one treatments to ameliorate a lot of these symptoms in women who are eligible and who want to. And including things like bone mineral density loss and heart disease risk as well. And I think there's a lost generation of women who felt that it was too dangerous to even consider HRT. And in those women, I think, you know, there's a huge injustice that has been done there. Because HRT as a hormone replacement model is a great way to ease that hormonal transition. Rather than going through all those fluctuations, you're replacing a lot of the hormones that you would have otherwise lost.

• 1:04:48Gemma Newman?

  And you're maintaining your bone mineral density. You can improve a lot of the bone ache issues. You're actually reducing potentially your risk of heart disease as well. But there is a window of opportunity with regard to heart disease risk. And that's around the menopause. Like if you're within 10 years of menopause or less than the age of 60, that would be a good time to reduce your risk of heart disease moving on in life. And the same with the bone mineral density loss, there's that window of opportunity there. In that sort of five to 10 year window between sort of, you know, 45, 55, where if you are eligible, it's worth at least exploring the idea of HRT.

• 1:05:29Rich Roll?

  Right. So with that in mind, how safe or unsafe is HRT in general now? And what are the factors that determine whether a woman is a good candidate for this?

• 1:05:41Gemma Newman?

  Yeah, so there will be certain women that are not eligible for HRT, primarily those who've experienced breast cancer. But there are other potential reasons why they wouldn't want to have HRT as well. Obvious things like pregnancy, or a recent blood clot, or an undiagnosed bleed, for example. But in actual fact, I would say excluding those women, most women would be pretty good candidates for HRT. The main problem that really scared a lot of women back in sort of 2002 was the Women's Health Initiative study, which showed that there was a potential increased risk of breast cancer.

• 1:06:23Gemma Newman?

  In fact, the study was halted early over concerns about excess breast cancer risk. And Unfortunately, the headlines around that study went around the globe and made the use of HRT drop by about sixty-six percent.

• 1:06:40Rich Roll?

  In other words, the headlines being something along the lines of HRT will cause breast cancer?

• 1:06:45Gemma Newman?

  Yeah, exactly. And it scared, it scared everyone. It scared doctors, it scared women who were taking HRT. So many women stopped taking it. But interestingly, Professor Langer, one of the principal investigators on that study, wrote a paper condemning the headline of the study as being irresponsible and wholly inaccurate. And many of the lead investigators on that study were not consulted before it was even published. And one of the main problems with the study was that they used women aged sixty-five or thereabouts, and they were starting HRT brand new. And of course, by that stage, a lot of those risk factors for breast cancer and excess risk of heart disease, for example, were

• 1:07:27Gemma Newman?

  already in existence before they began the treatment. And I do believe it's let down a whole generation of women. There was a really interesting study in the BMJ from 2012 that showed that if you take HRT for a period of five years, you actually have reduced risk of heart attacks and heart failure. There was no increased risk of breast cancer or blood clots at all. And there was an interesting study by David Katz, actually, in 2013. And he estimated that in the twenty years after 2002, that there were anywhere between around twenty to ninety thousand women who died prematurely from not having access to HRT

• 1:08:08Gemma Newman?

  because of the protection it can offer for heart disease and bone mineral density loss, as well as, obviously, all of the other symptoms that we've talked about, you know, with the flushing and the mood changes, and the way, the vaginal atrophy, and the way that these things can impact their lives day to day.

• 1:08:25Rich Roll?

  And the optimal time to begin HRT would be early in menopause, right? Before you've already suffered bone loss and all these other ramifications?

• 1:08:34Gemma Newman?

  Yeah. And it's, I mean, the age of menopause does vary. The average age is about fifty-one, but it's normal for it to start anywhere between ages of forty-five to fifty-five. And I think it's actually vital to think about, if you're going to, think about starting it then, because you are preventing, it's a prevention, isn't it? So you're preventing the bone mineral density loss, you're preventing the atherosclerotic plaques that we start forming because of the lack of estrogen in the body and how that's cardioprotective. And it's a way of then, you know, essentially lengthening your time where you're sort of functional and you're not having some of these problems.

• 1:09:13Rich Roll?

  Mm-hmm.

• 1:09:14Gemma Newman?

  Yeah.

• 1:09:15Rich Roll?

  And what is the composition, like what is the hormonal composition of HRT?

• 1:09:20Gemma Newman?

  So it's basically a combination of estrogen and progesterone. Interestingly, if you have estrogen-only HRT, then there's absolutely no excess risk of breast cancer at all. But the reason that progesterone is often added is to help protect the womb lining. Because if you have a normal womb and you just give unopposed oral estrogen, then you could have excess risk of bleeding and increased risk of endometrial cancer, which is why progesterone is given in combination with the estrogen replacement. But if we look at, I mean, there's loads of different types and formulations of HRT. But I do want to stress that if you're going for like the gold standard, which would be

• 1:10:02Gemma Newman?

  an estrogen gel or an estrogen patch alongside micronized progesterone, then taking that for about five years, there was a systematic review to say that there was absolutely no increased risk of breast cancer at all. So I'd love for women to know that, that if they want to look into it, they should. It comes, as I say, in the form of patches, gels, tablets, and yeah, there's loads of different brands, but essentially it's just estrogen and progesterone.

• 1:10:35Rich Roll?

  Mm-hmm. And what percentage of women currently are on HRT? Is it a low percentage?

• 1:10:41Gemma Newman?

  It's low and it's increasing gradually. I think it was probably at its lowest just after the 2002 study. It's gradually creeping up, there's a lot more awareness now about menopause and the symptoms, especially in the UK. I don't know if that's translated over here in such a big way, but I get lots more women coming to me in clinic asking about HRT, which I'm really pleased about because so many women over the years have said, oh, it's not natural, it's not for me.

• 1:11:12Gemma Newman?

  And it's harmful, I'm worried about breast cancer. And I want women to know that it's a very valid option. And it's actually, the menopause guidelines suggest that it's the number one treatment for bone mineral density loss, as I mentioned.

• 1:11:26Rich Roll?

  Wow. Yeah, you mentioned the word "natural." There is an interesting thing within wellness and holistic health circles that, you know, obviously are going to prioritize natural remedies, food is medicine, et cetera, at the cost of medical interventions that could be helpful, right? So, there's a weird, in the Venn diagram, between evidence-based medicine and lifestyle protocols and the kind of organic wellness, alternative holistic health. I could see a tension between those two things. Like, somebody who's like, "Well, I'm just going to eat organic food." You're saying, "Yes, but this intervention could be beneficial, but hey, that's not really part of my protocol.

• 1:12:08Rich Roll?

  I'm trying to not be on any kind of exogenous interventions."

• 1:12:14Gemma Newman?

  Yeah, and that's something that I respect. If someone doesn't want to take extra hormones, then they shouldn't have to. And I completely understand that perspective. I think what bothers me is the idea that the choice of women is often taken away because of unfounded fears. And I think, for me, it's important to be able to offer something that could benefit. And whether women want to have it or not is up to them. But we have to consider what's really natural, I guess, in the environment that we're currently living in. I mean, you could say it's natural to die in childbirth, because if you're in Afghanistan and you're in a village somewhere, you've got about a 1 in 14 chance of dying from childbirth. Is that natural?

• 1:12:58Gemma Newman?

  Yes, I suppose it is, but it's clearly not something that anybody would wish to happen. And so, I think, when it comes to severe menopausal symptoms, but also longevity, I want to be able to provide women with every possible option that is deemed to be healthy and appropriate. And if they want to take it, they can.

• 1:13:19Rich Roll?

  Right. You mentioned earlier that the age at which...

• 1:13:25Rich Roll?

  Young women are experiencing their period is getting earlier and earlier. Is there also a change in the window for menopause? Like, is that happening earlier also?

• 1:13:35Gemma Newman?

  No, so I think it may, it may be, again, a reflection of Western society and the various exposures that we have, but menopause in some cultures is actually seemingly getting a bit later.

• 1:13:48Gemma Newman?

  There is some potential genetic differences in when you would start the menopause anyway. So, for example, black women may find that they start their periods on average about forty-eight, forty-nine, whereas white women may start on a, on average about fifty, fifty-one. But yeah, I think menopause can vary based on diet as well. There was an interesting study to show that eating more vegetables could potentially bring the age of menopause slightly younger. Again, not dramatically, like maybe three months on average. They were looking at sort of large population data, but I think that's very interesting because, again, it speaks to the effect that our diets can have on our normal physiological processes.

• 1:14:32Rich Roll?

  Is there a mode of eating or particular foods that could lessen some of the negative symptomology around it?

• 1:14:41Gemma Newman?

  Absolutely, and I'd say, again, I'm going to bang on about fibre. Fibre is crucial and minimally processed soy products are really beneficial as well. Making sure that you have a nice variety of things like nuts and seeds for extra minerals like selenium are important. Even sort of things like, I know we haven't touched on thyroid function, but again, that's another hormonally regulated organ. You want to be able to make sure that you're having great sources of iodine, selenium, zinc, and that's true for all of the hormones in the body, but especially things like the thyroid.

• 1:15:14Rich Roll?

  And what are some of your favourite foods that are high in those things?

• 1:15:19Gemma Newman?

  So with selenium, you could just have like a Brazil nut a day. That would be pretty good, but it's also in whole grains, whole grain rice, whole grain bread, other nuts and seeds, and the same with zinc as well, which again is important for things like sperm production. I know we're not talking about men, but sperm production.

• 1:15:39Gemma Newman?

  Yeah, so there are loads of great foods. So just think fruits, veggies, whole grains, beans, soy products. I'm a big fan of flaxseeds, just because they're great at helping to improve the suppleness of blood vessels. And yeah, they've got loads of great omega threes from plant sources as well.

• 1:15:58Rich Roll?

  Just make sure you grind them first.

• 1:16:00Gemma Newman?

  Grind them first.

• 1:16:00Rich Roll?

  Otherwise, they pass right through.

• 1:16:01Gemma Newman?

  Yeah, exactly.

• 1:16:04Rich Roll?

  Let's talk about male hormonal health. Is, you know, is manopause like a real thing? And also, you know, I'm interested in your thoughts on TRT because it's obviously the other side of that coin.

• 1:16:16Gemma Newman?

  Yeah, so I think that for men, I mean, I don't have personal experience of this, but certainly with my patients, it doesn't seem to be as much of a thing for men as for women. And I mentioned earlier, I think it's because it's a very gradual decline. Like with most of the hormones in our body, testosterone production can start to wane over time. So, you know, I think in certain conditions, it might be beneficial for testosterone replacement, but I don't see it as being something as vital for male health as estrogen replacement would be for female health, based on the changes in the body that occur for women that just simply don't occur for men.

• 1:16:56Rich Roll?

  Yeah. I know so many guys my age that are on testosterone therapy. I'm not, but they talk about it. You know, it's something that guys of my age, you know, tend to, are you doing that? Should I do that? Should I not do that? Are there negative health outcomes with respect to that? My understanding is that if you get on it, then that's it. You have to stay on it. Because obviously, if you're taking it exogenously, then it's going to shut down your bodies, whatever your body is, is making, right? Like, it's telling your body, like, you don't need to make any of this because you're getting it.

• 1:17:31Gemma Newman?

  Yeah, I think this is where men should be cautious and speak to their own doctors about whether it's necessary or not, especially if you're somebody that is actually hoping to perhaps father a child at any time. Because like you say, you're turning off your own testosterone production there, whatever is still going on. And that can have ramifications for your fertility. So I think that that probably be the main consideration, depending on the intentions of the person that wants to take testosterone replacement, just to think carefully about if it could actually impact their fertility. But, yeah.

• 1:18:04Rich Roll?

  Most guys my age are probably, they're not worried about that part.

• 1:18:07Gemma Newman?

  Yeah.

• 1:18:08Rich Roll?

  Actually, they want the opposite. Not everyone, but.

• 1:18:12Gemma Newman?

  Yeah, so, yeah, it's, it's not something that is as prevalent, or indeed, I don't believe as necessary for men as it is for women. But it's a conversation I think is occurring a lot more in wellness spaces.

• 1:18:24Rich Roll?

  What would be the reason for doing it?

• 1:18:27Gemma Newman?

  Probably to increase things like muscle mass, mood changes sometimes that can occur in men, as, as the testosterone levels that you're endogenously producing fall. Yeah, I think one of the main reasons that my patients would go on testosterone replacement is if they have excess estrogen exposures, so it tends to happen more when men are carrying excess weight as well, that, because as I mentioned before, the fat cells can produce estrogen, which can have perhaps a slight feminizing effect. So, yeah.

• 1:19:04Rich Roll?

  What else is unique to male hormone health that you can speak to?

• 1:19:09Gemma Newman?

  I think one of the main things that is worth talking about for male hormone health is the gradual decline, or the gradual apparent decline in sperm counts over the course of the last couple of generations, and the increased rates of something called hypospadias, which is where the urethra, the wee tube, sort of forms and grows on the underside of the penis. And the increased rates of only having one testicle at birth. This is something that I suspect is related to, again, the plastic exposures in our environment, the phthalates exposures.

• 1:19:48Rich Roll?

  I didn't know that that was a thing.

• 1:19:51Gemma Newman?

  Yeah.

• 1:19:52Rich Roll?

  Increase in men being born with one testicle.

• 1:19:54Gemma Newman?

  Yep.

• 1:19:55Rich Roll?

  What percentage of the population?

• 1:19:57Gemma Newman?

  I don't know the percentage.

• 1:19:58Rich Roll?

  Significant enough that it's?

• 1:20:00Gemma Newman?

  It's been, it's been noted to be increasing. And, again, as I said, the hypospadias issue as well, where there's a sort of a distortion to the penis as a result of. Changes in the exposures in the womb, basically, because obviously this is the way that the baby has been born.

• 1:20:17Rich Roll?

  Mm hmm.

• 1:20:17Gemma Newman?

  And yeah, I do see that there is a correlation there between that and increased rates of exposures to things like microplastics, thorn dates, BPA, and it can potentially affect sperm counts too. So, simple things that I think men could do that would be useful would be, I mean, studies have shown that vigorous exercise is quite good for sperm count, assuming that you're not putting too much excess heat on the testicles themselves, because like, for example, with cycling or hot baths, because that can have an impact on the sperm production. But otherwise vigorous exercise is good. Sources of zinc and selenium, as I mentioned, things like nuts and seeds are really helpful. Coenzyme Q10, again, that can come through those kinds of healthy foods, nuts, seeds, whole grains.

• 1:21:00Gemma Newman?

  Yeah, and minimizing plastics exposures generally, which I think probably the low-hanging fruit would be to drink your water from glass rather than plastic, to avoid something that's come in a plastic bottle if it's been sitting in the heat, like in your car, if it's a hot day, for example.

• 1:21:19Rich Roll?

  And you don't know, it could be in a, you know, in a cooler in the grocery store, but it had to be transported from somewhere, it could have been on a truck for days or weeks.

• 1:21:29Gemma Newman?

  That's true.

• 1:21:29Rich Roll?

  In excruciating heat.

• 1:21:30Gemma Newman?

  That's true, we just don't know.

• 1:21:31Rich Roll?

  But getting rid of plastic, I mean, it's so hard.

• 1:21:34Gemma Newman?

  It's so hard.

• 1:21:35Rich Roll?

  It's so completely ubiquitous.

• 1:21:37Gemma Newman?

  I know, and I'd say it's almost impossible. I think recently there was a study to show that it's been, microplastics have been found in the human bloodstream. It's something that we, we can't escape at this point, but we can minimize. And, you know, I, I don't want people to come away from this conversation feeling scared. I think I'd rather they feel empowered to know there's a few things that we can do to minimize our overall exposure, and that would be heating, if we're using a microwave, for example, then just put it in ceramic or in glass as you heat it. You know, if you're drinking water, drink it from a bottle, maybe if you can invest in a water filter, do so. Simple things that hopefully will, over years, accrue to benefits.

• 1:22:17Rich Roll?

  What about the role of dietary fats and hormone health?

• 1:22:22Gemma Newman?

  Yeah, interestingly, I have read data to say that saturated fat consumption has been associated with lower sperm counts in men, so that's something of interest. We also know that when you're eating a high saturated fat diet, then it tends to be mostly from animal products, and again, you've got those extra plastics exposures and things that can affect hormonal health from there, so it's hard to necessarily separate the two. But in a more general sense, we have lots of data to show that a saturated fat-rich diet is very linked to things like heart disease. And public health campaigns can make a difference. So, you know, I know that there may be listeners that think, oh, well, you're only feeling better because you're eating more whole foods, and it's fine to have things like, you know,

• 1:23:07Gemma Newman?

  grass-fed beef and so on. But if you look at data from countries like Finland, for example, they had the highest rates of heart disease in the world back in the 1970s. They wanted to do something about it. They had a massive public health campaign. Many people reduced their red meat consumption, stopped smoking, ate more vegetables, and then, you know, moving fast forward about 20, 30 years, they've managed to reduce the heart disease rates by 80%. So, we can see that these are basic, simple things that people can do that can have tremendous impacts on our health moving forwards.

• 1:23:42Rich Roll?

  Right. Within the whole food, plant-based community, there's varying opinions about the positive or negative consequences of fats in the diet. We have the Caldwell-Essexton camp, which is very low-fat, no oils. Typically, that protocol is something that's advised for people that are experiencing heart disease or have suffered some sort of atherosclerotic event. And then there's another camp of people who are saying that's hyperbole. A healthy dose of olive oil in your diet is fine. Like, how do you come down on this, you know, hot debate? Like, this is very divisive.

• 1:24:25Gemma Newman?

  It is divisive, and I hate divisive debates.

• 1:24:30Gemma Newman?

  So I try and stay out of them. I don't know if you noticed, but I don't tend to get into it online.

• 1:24:34Rich Roll?

  Well, I'm gonna put you square in the middle of it right now. You're gonna have to state your position.

• 1:24:38Gemma Newman?

  Okay, so my position is we have to eat more veggies, as I mentioned before. That's the number one.

• 1:24:43Rich Roll?

  You're dodging it. That's a dodge. If I ever heard one.

• 1:24:47Gemma Newman?

  Okay, looking at the data that we have, I think it's fair to say that if you're having good quality olive oil with polyphenols in it, it can have some health benefits. I don't think that having olive oil in your diet is an unhealthy thing to do. And I think a generally Mediterranean style of diet is known by many people, many nutrition researchers, to be one of the best ways of eating for overall health, which includes olive oil.

• 1:25:18Gemma Newman?

  Yeah, I don't think that for the majority of people, having oil here and there is going to be at all harmful. I'm not somebody that thinks that seed oils are particularly harmful either, because, you know, they are rich in poofers and moofers, polyunsaturated fatty acids, monounsaturated fatty acids, which we know are beneficial to health if you're replacing saturated fats in the diet with those kinds of oils. So, yeah, I think it's hard to sort of come down hard and fast, but I'd say, looking at the data that we have, trying to compare one thing to another, seed oils have no demonstrable issues when it comes to heart health.

• 1:26:00Gemma Newman?

  But I would say that if you are aiming to lose weight, then it's not a great idea to have a lot of things like seed oils in your diet, because they're very calorific and they don't really contain a lot in terms of the nutrients that you'd be looking at to help fill you up, like the fiber-rich foods would. And also, I have a certain cohort of patients, certainly, that notice when they have a lot of oils in the diet, that it can flare up things like inflammatory arthritis. And I think it would be remiss of me to avoid mentioning that, that certain people... Who have a whole food, plant-based, no-oil diet find that it's beneficial for inflammatory arthritis as well as potentially beneficial for heart disease.

• 1:26:42Rich Roll?

  Right. And I would assume there's a difference between raw olive oil that you sprinkle on a salad versus cooking with it, like the oxidative impact of high heat on some of these oils. That's a whole different thing.

• 1:26:56Gemma Newman?

  It is, although I would say that the heat at which most people cook at home is not going to cause too much oxidation of olive oil. I think that's something that's probably overstated.

• 1:27:05Rich Roll?

  What is the oxidation temperature point, do you know?

• 1:27:08Gemma Newman?

  I don't remember, Rich. You put me on the spot there.

• 1:27:11Rich Roll?

  I stumped you.

• 1:27:12Gemma Newman?

  Yeah.

• 1:27:13Rich Roll?

  I know that, like, well, you know, every oil has a different.

• 1:27:17Gemma Newman?

  Smoke point.

• 1:27:18Rich Roll?

  Yeah, smoke point, right? So coconut oil is much higher.

• 1:27:21Gemma Newman?

  It is.

• 1:27:22Rich Roll?

  It doesn't oxidize until you get super hot, so it's sort of advised that if you're going to cook with one, that's the one to cook with.

• 1:27:27Gemma Newman?

  Well, that depends, because coconut oil also contains saturated fat, which is still saturated fat, even though it comes from a plant. So I think if someone wants to concern themselves with the smoke point, then avocado oil is probably a good choice, or cold-pressed canola oil would be a good choice as well.

• 1:27:50Rich Roll?

  That's always been the one, the number-one enemy one.

• 1:27:52Gemma Newman?

  Sorry, but the data suggests, the data suggests that cold-pressed canola oil is a pretty good oil to cook with because it contains the, you know, the unsaturated fats and it has a higher smoke point, so yeah. If you don't want to cook with it, you don't have to.

• 1:28:11Rich Roll?

  Controversy. In the daily practice of being a doctor and seeing patients, what do you find to be, you know, when you're in this discussion around changing your lifestyle, maybe adopting a more plant-predominant diet, and then following up with these people, like, what do you find to be the common blind spots or stumbling blocks or places where people can go astray?

• 1:28:36Gemma Newman?

  I think our food environment is probably the biggest thing, so.

• 1:28:42Gemma Newman?

  We seem to have this feeling in the wellness space that we are all individuals and unique and we can make choices that are not unrelated to other things in the world. And actually, most of the choices we make around food are unconscious choices about, I think UCL research stated that there was over 200 unconscious food choices that we make every day and only about 13 to 15 conscious food choices.

• 1:29:07Rich Roll?

  Wow. I didn't know that we made that many food choices in a day, period.

• 1:29:12Gemma Newman?

  Well, exactly, but that's what fascinates me is to think when the research tells us that so many of the factors that control what we eat are actually out of our conscious mind, it's much harder then to make changes for the long term that are healthy, especially if you don't have the mental bandwidth or the budget to think about these things. Having said that, we know that whole plant foods can be some of the cheapest things you can buy, as long as you can get access to them. So, one of the main stumbling blocks for me has always been people's habits and ability to have the bandwidth to make those changes mentally. So, I really start simple, just go for very simple swaps, find their favorite meals

• 1:29:55Gemma Newman?

  and make them with more plants, basically. Maybe get them to write down the favorite things that they like to cook and add more beans, add more lentils, add more vegetables, and then gradually crowd out the other things. It's been one of my number one sort of ways to get people to eat more veggies.

• 1:30:12Rich Roll?

  Yeah, I feel like it's two main things. One, which you just referred to, which has a lot to do with being more conscious about the environment that you keep. Like, if you can create an environment where the healthy choice is the most convenient because you've cleared all the bullshit out of your cabinets and you only have healthy choices and when you wake up in the middle of the night, like, sorry, you know, it's gonna have to be...

• 1:30:40Gemma Newman?

  You've got the munchies, you get your carrots out.

• 1:30:41Rich Roll?

  Yeah, you know, that Ben and Jerry's just ain't there. So, it's about a conducive environment to making the better choice. But I think perhaps even the bigger issue and stumbling block is really the social issue. Like, people get all up in their heads about... What other people are going to think about them? What's going to happen when they go to Susie and Dave's, you know, dinner party? And they don't want to make a fuss? Or I have to go on vacation with my neighbors? And, you know, it's just going to be too problematic. And people like relinquish their boundaries? Or, you know, are just too afraid to, to stand up for themselves? Or to like make that conscious choice? Because they don't want to be difficult.

• 1:31:22Gemma Newman?

  Yeah, I can totally relate to that. Because that was my instinct, first of all, when I started on this journey. My main thought was, oh, this is going to be so awkward for everybody. People are going to think this is so strange. You know, it's, I think as social creatures, it's one of the main considerations that a lot of people have. And I guess it comes down to living in alignment with the things that you most want. And do you most want to be somebody that pleases others? Do you most want to be somebody that lives in alignment with things that are important to you? Are those things one and the same? If you can have a conversation with yourself around the values that you're living by,

• 1:32:05Gemma Newman?

  it becomes much easier to then make conscious choices that are in alignment to those values. So I would actually encourage everybody to have this conversation with their loved ones, or even just with themselves. They could write it down in a journal, write down their top values in life, and how their food choices can relate to those values. And then it becomes a lot easier because you're taking away a lot of the extra choices that you're having to make, or the social situations that you're having to navigate. Because you are consciously living in alignment with the things that matter. So if it matters to you to minimize your risk of heart disease, because you have a relative that died young, you want to see your children grow up, then you write that down.

• 1:32:47Gemma Newman?

  And you find ways to make it work within that kind of framework, if you like, your values framework. If animal compassion is important to you, it's probably a lot easier because you've already made that decision for another outside purpose. It's something that's outside of yourself. And perhaps the same can be true for someone that cares deeply about the environment and the planet. They've already made that decision based on a value that's so strong to them that it actually makes it a little bit easier to stick to. I think health. Overall, it's probably one of the first ways people go towards plant-based nutrition, but it's also one of the hardest ways to stick with it if that's your only goal, because it's quite self-focused.

• 1:33:25Rich Roll?

  Mm-hmm.

• 1:33:25Gemma Newman?

  Whereas if you can focus on something outside of self, then it potentially could make those choices a lot easier. Either environmental health, or animal compassion, or reasons to stay healthy for others. It tends to be, in my experience, ways that make it stick a lot more.

• 1:33:40Rich Roll?

  Yeah, that's a really good way of thinking about it. One of the questions that I get all the time, I'm sure you do as well, is, "I want to do this, but my partner doesn't want any part of it." And you began this journey, Richard was doing it ahead of you, two different dinners, meals, et cetera. But for a lot of couples, that becomes very problematic, especially when those values might come into conflict with each other.

• 1:34:03Gemma Newman?

  Yes, you're so right. And I think my advice from that, being the partner that was most reluctant, perhaps I can speak to this more, is the idea that what I needed was patience and time. And sometimes people will never come around. Sometimes the people you love the most will never want to do the things that are important to you when it comes to diet. And I think that taking away that expectation is important, because when you start to expect things of other people, that's where you can start to become very unhappy. You know, it builds kind of criticism in your mind, it builds comparison, it builds expectation,

• 1:34:47Gemma Newman?

  and that can be quite toxic for your relationship. So my best advice is just to do the thing that's making you happy, do the thing that brings you in alignment with who you want to be, and show your partner through your actions how much happier, how much healthier, and how much more abundant you feel in your life. And then if they want to come along for the ride, they can.

• 1:35:08Rich Roll?

  Right, but you have to be detached from that expectation. Otherwise, you're going to be vibing them all the time, and then that piousness creeps up, and then it just becomes a disaster.

• 1:35:19Gemma Newman?

  Exactly, you've got to let that go.

• 1:35:22Gemma Newman?

  You just gotta let that go.

• 1:35:23Rich Roll?

  Even if it's in the back, well, if I keep doing this, they'll eventually come around. It's no.

• 1:35:28Gemma Newman?

  No.

• 1:35:28Rich Roll?

  You gotta like, get rid of that.

• 1:35:29Gemma Newman?

  I, I do think that that's probably the best way for you to sustain a healthy relationship with the people that you love the most. And it's hard because often the people you love the most may you feel need it the most, especially if they have a health condition that could benefit from doing that. But you have to let it go because it's not your life, it's their life.

• 1:35:46Rich Roll?

  I mean, that's advice for this particular scenario, but for, you know, a zillion others as well, like in terms of like partnership dynamics.

• 1:35:55Gemma Newman?

  Yeah. And in a partnership, you will often have expectations of a partner that are unspoken. And that could be true for any kind of scenario. And that's not to say that you shouldn't communicate the things that are important to you. Of course you should. But it's the expectation that is attached to that, which I think can become very negative in, in the relationship. So letting go of the expectations of your partner is probably the key to a happier life in all sorts of ways.

• 1:36:23Rich Roll?

  Did Richard do that?

• 1:36:24Gemma Newman?

  Yeah, he was very patient with me. In fact, when, at one point, I think, because steak used to be my favorite meal and burgers. I'd always order burgers when I was out and steak, I loved steak. And once he even cooked a steak for me, that shows how much he loves me.

• 1:36:40Rich Roll?

  Hmm. Oh, strategic.

• 1:36:44Gemma Newman?

  Yeah, exactly. It's like reverse psychology.

• 1:36:46Rich Roll?

  Right. So it was in the back, oh, if I do this, right?

• 1:36:50Gemma Newman?

  Yeah.

• 1:36:50Rich Roll?

  Who knows? But that brings up an important issue, which is, you know, somebody who's listening to this or watching it is thinking, well, my life is just going to become infinitely more complicated. It means like, we're going to have to prepare two different meals. I'm going to have to spend all this time in the kitchen. I'm going to have to plan out everything in advance. It's probably going to be expensive. And suddenly, my life, which was kind of going along pretty good, suddenly gets hijacked by this new lifestyle habit that is going to commandeer all my time, energy and money.

• 1:37:19Gemma Newman?

  And is that the person that's wanting to start this? Or is this the partner of the person that's wanting to start this?

• 1:37:24Rich Roll?

  It's the plant curious person who's contemplating the change, but now suddenly feels like maybe this is a little bit too difficult.

• 1:37:31Gemma Newman?

  Yeah. So it's kind of moving from contemplation to action that people tend to have a stumbling block with.

• 1:37:36Rich Roll?

  Right. Well, they're hearing you and they're like, well, my partner's not going to be into this. So am I willing to?

• 1:37:41Gemma Newman?

  Rock the boat.

• 1:37:41Rich Roll?

  Yeah, do this thing that's going to, you know, potentially cause. Fishers in my relationship and you know, take up a lot of my time.

• 1:37:50Gemma Newman?

  Yeah, and those are valid, very valid concerns. And I guess what I'd say to that person is you have to find the thing that helps you know where you're going for the future. I think a lot of the time we kind of coast through and we do things because they are the path of least resistance. And sometimes the path of least resistance is a great path and it works and everything's going well. But sometimes over the course of maybe weeks, months to years, we start to notice actually this isn't really working for me anymore. You know, although this is the easier route, I'm not feeling this.

• 1:38:31Gemma Newman?

  I either don't feel healthy or there's something niggling me in my conscience about things I want to do differently. And sometimes changes do require a certain amount of forward thinking. And sometimes the biggest changes that we make in our lives are as a result of pain points, things that come up in our lives that we don't like.

• 1:38:54Rich Roll?

  Hello.

• 1:38:54Gemma Newman?

  Yeah, exactly. Pain can be our biggest teacher. And for those who are hoping to start making changes, but that pain point isn't quite there yet, then maybe they won't make a change. Maybe this won't be the right time for them. But my hope is that if we plant these seeds together today, some people will have enough water to plant, you know, to water those seeds. And other people may have enough sunlight to provide those seeds with a little bit of sunshine and maybe those seeds will grow into plants of change.

• 1:39:26Rich Roll?

  Sure.

• 1:39:27Gemma Newman?

  Based on today.

• 1:39:27Rich Roll?

  So the person who's sticking that seed into the soil right now and getting ready to water it, but doesn't know how to water it, like, how do you think about the early phases of this? Like, I'm somebody who went all in. That's just my personality type. I recognize most people aren't like that. I suspect you're somebody who would counsel people to make tiny changes, master them. Like, how do you get somebody engaged in this and give them some actionable advice about how to begin in a very practical manner?

• 1:39:58Gemma Newman?

  So number one is literally write down the foods that you buy in your weekly shop. Number two is write down all the foods that you make with those ingredients. And if you can find one meal a week that you'd like to have more plants in, then that can be your first step is literally just cook one meal a week that is plant-based and see how you feel. And then if that works for you, then you can cook another one and then maybe cook another one.

• 1:40:27Rich Roll?

  Yeah, but all I do is eat takeout.

• 1:40:30Gemma Newman?

  Well, if you eat takeout, then interestingly in the US, I don't know if it's the same, but in the UK, we have a pretty good plant-based ready meal range in a lot of our supermarkets. And interestingly, I had a patient who was elderly, type 2 diabetic, never cooked for himself. And I said to him, why don't you just swap that one ready meal that you buy for this ready meal, which has all plants in it. And in doing so, he was able to come off insulin and improve his type 2 diabetes. So there's always a starting point for everybody. If you're somebody that just eats takeout, then you know what, for you, the best thing would be perhaps just to start with one home-cooked meal a week rather than trying to change everything.

• 1:41:12Gemma Newman?

  Just cook one meal at home rather than having all meals takeout. For my elderly patient who was just eating like small ready meals from the supermarket, switch to a plant-based one and see how you feel. See if it changes your health over time. So it's just, it is for a lot of people about those baby steps.

• 1:41:30Rich Roll?

  Yeah.

• 1:41:32Gemma Newman?

  For others like you, they jump in and they'll get started and they'll figure it out along the way and they'll enjoy that process and that's great. But for most people, it's just little steps. And you know, there was research by BJ Fogg to show that only one, one change is enough to then start changing, shifting that identity and then sort of adding in something new after that. So yeah, just one thing, one thing is all you need to do.

• 1:41:55Rich Roll?

  I'm getting BJ Fogg in here. I've been going back and forth with him on email forever.

• 1:41:59Gemma Newman?

  Yeah.

• 1:42:00Rich Roll?

  He's getting in here soon, though. Yeah, I like that idea. I mean, I think, you know, in listening to you, I'm reflecting on some of my habits now and what I find myself doing from time to time. When I'm busy or Julie's out of town, or she's like, I'm not cooking tonight. I go get plant-based takeout, but you have to be really careful because when you're getting takeout food, you're not preparing the food. There's going to be more oil in it than you think. There's going to be more salt in it than you think. And if you're opting for some of these meat and dairy analogs, like, maybe not so good. Not all of them, you know, they're all, it depends on what, you know, because there's a spectrum

• 1:42:40Rich Roll?

  and in terms of health, you know, the health factors that are, you know, what these things are about. But how do you think about the, you know, the Beyond Burgers and the Impossible Burgers and all of that kind of stuff?

• 1:42:54Gemma Newman?

  I like to be fairly practical in the advice I give to people. I think if somebody likes the taste of an Impossible or a Beyond Burger and wants to have it once or twice a week, then there's no reason why they shouldn't for the most part.

• 1:43:05Rich Roll?

  Especially early.

• 1:43:06Gemma Newman?

  Exactly.

• 1:43:06Rich Roll?

  In the transition.

• 1:43:08Gemma Newman?

  But then, having said that, you know, there is interesting data emerging. There was a study that one of my friends did, actually, on a specific brand of plant-based meat replacement, meatballs and mince. And in the study, families were given these meat replacements to use alongside the normal meat and other foods that they would prepare. And what they found is that in the families that had the meat replacement, they had a favorable change in their microbiome over the course of those, I don't remember how many weeks the study was, but it was perhaps about four weeks to my recollection. They had really great shifts in their microbial health from using meat replacement analogs.

• 1:43:50Gemma Newman?

  So I think we do need more research to understand the effect on the body, but we do also know that for, you know, in the majority of these meat replacement analogs, there will be less saturated fat. There will be less or no heme iron, which are both potential issues when it comes to heart disease risk and inflammation in the body. And, you know, I think they are too easily demonized by a lot of people. And yeah, that's that's my take on it. I wouldn't say you should have them every day.

• 1:44:19Rich Roll?

  Yeah.

• 1:44:20Gemma Newman?

  But it's the same with any kind of food. It's great to have variety and whole foods as your main go to. But I think a lot of people are too quick to to cast off these meat replacements.

• 1:44:30Rich Roll?

  Right. Yeah. Well, again, it's a spectrum, some are worse than others.

• 1:44:34Gemma Newman?

  Yeah.

• 1:44:35Rich Roll?

  And there's a difference between health promoting and neutral versus deleterious to your health.

• 1:44:40Gemma Newman?

  Exactly.

• 1:44:41Rich Roll?

  I think what what is becoming a bigger issue over time is that now there are so many products out there that taste really good and you can kind of psychologically rationalize eating them like, oh, it's it's vegan, it's plant based, like, it's got to be good for me, right?

• 1:45:01Gemma Newman?

  Yeah.

• 1:45:01Rich Roll?

  And and wake up only to realize like you're, you know, you're just eating french fries and Beyond Burgers all the time. That's not a whole food, plant based diet. And it becomes incumbent upon you to like, really make sure that you're eating plant foods close to their natural state, as wide a diversity as possible, rather than diluting yourself that because you're not eating cheeseburgers, you're eating a plant version of that, that so you know, you're going to sidestep heart disease, right?

• 1:45:27Gemma Newman?

  Yeah, exactly.

• 1:45:28Rich Roll?

  So.

• 1:45:28Gemma Newman?

  Yeah, that's.

• 1:45:29Rich Roll?

  And it's it's hard. It's kind of like the stuff finally tastes good for the most part, and it's going to continue to get better and better and better. I think what we're going to see is like a split. We're going to we're going to have foods that that are going to taste exactly like that thing, but they're going to be probably on the more unhealthy side. And then there's going to be other companies who are creating plant analogs to some of our favorite foods that are doing it with health in mind and lesser ingredients and natural ingredients. And my hope is that there's a lot of focus and energy and money going into that right now, because I think that's what we need more of.

• 1:46:03Gemma Newman?

  I agree with you. I would. I think that you're absolutely right. We want minimally processed, less ingredients, more whole food based analogs for sure. And the the ingredients do vary really widely. So, yeah, I think. When you look at the data on plant-based diets and the Healthy Plant-Based Diet Index, which was really interesting data, you see, as you pointed out, that if you're having an unhealthy plant-based diet with things like, you know, french fries and ice cream and all the things that you can essentially-

• 1:46:38Rich Roll?

  Coconut ice cream and Oreos and potato chips.

• 1:46:40Gemma Newman?

  Oreos, yeah, crisps, potato chips, all of that kind of stuff, you're not going to reap the same benefits at all. And you're right, people can delude themselves to think, "Oh, well, it's healthy because it's plant-based." Well, it's not always.

• 1:46:51Rich Roll?

  So what's your day in food look like?

• 1:46:53Gemma Newman?

  Oh, I love, oh, what do you call it here? Oatmeal. I call it porridge.

• 1:46:59Rich Roll?

  What do you call it? Porridge. That's what they call it in, what's your town called again?

• 1:47:04Gemma Newman?

  Where I live?

• 1:47:05Rich Roll?

  Yeah.

• 1:47:06Gemma Newman?

  Buckinghamshire.

• 1:47:06Rich Roll?

  Right, of course. It's like the most British thing ever.

• 1:47:09Gemma Newman?

  Sorry.

• 1:47:10Rich Roll?

  Okay.

• 1:47:10Gemma Newman?

  Yeah.

• 1:47:11Rich Roll?

  And what part of England is it? Surrey?

• 1:47:14Gemma Newman?

  It's not, I work in Surrey.

• 1:47:15Rich Roll?

  You work in Surrey, okay.

• 1:47:17Gemma Newman?

  And I live in Buckinghamshire, which is kind of between, well, I live sort of near Windsor, where the Queen lives. So that's kind of near where it is. You'd probably know.

• 1:47:26Rich Roll?

  You just get more regal with every moment, Gemma.

• 1:47:29Gemma Newman?

  Well, I'm from Devon, which is not as regal.

• 1:47:32Rich Roll?

  That's down by the sea.

• 1:47:34Gemma Newman?

  Yeah.

• 1:47:35Rich Roll?

  Isn't that where Earthling Ed's, like, his fish, his plant-based fish restaurant is? Good Catch or something like that?

• 1:47:43Gemma Newman?

  I don't know, but I'd love it if it was, because Devon needs more plant-based options.

• 1:47:48Rich Roll?

  I think it is. I could be wrong, but anyway, go ahead. A day in the life of food.

• 1:47:52Gemma Newman?

  Oh, yes. So I forgot where I was going. Yep. So I love porridge. I love to put flax seeds and chia seeds in it, berries, almond butter. You've got a lovely mixture of whole grains. You've got your nuts. You've got your seeds. You've got your antioxidant-rich berries. So, yeah, that's a real win for me. And, yeah, in my book, I've got a lot of wholesome recipes that are also kind of comfort foods, favorite comfort foods, like mac and cheese, which obviously doesn't have- Cheese in, but it's a nice kind of whole foods version. I love things like spaghetti bolognese, but rather than using mince, I use lentils and beans.

• 1:48:32Rich Roll?

  Mince is like meatballs in American.

• 1:48:36Gemma Newman?

  Oh, yeah, no, I don't know. Do you not have mince?

• 1:48:39Rich Roll?

  Mince, M I N C E, right? That's how you're spelling it? It's sort of like ground beef.

• 1:48:43Gemma Newman?

  It's like ground beef.

• 1:48:44Rich Roll?

  Right.

• 1:48:44Gemma Newman?

  Yeah, but I don't use ground beef, obviously. What do you call it?

• 1:48:48Rich Roll?

  I don't know, crumbles?

• 1:48:49Gemma Newman?

  Crumbles?

• 1:48:50Rich Roll?

  I don't know what we call it. What do we, what do we call it? Mince? We don't have a word for that. Chop meat. Chop meat?

• 1:48:56Gemma Newman?

  Chop meat.

• 1:48:57Rich Roll?

  Yeah, I don't know.

• 1:48:58Gemma Newman?

  There's lots of suggestions from all these different corners of the room. Yeah, so I love, I love comfort foods.

• 1:49:04Rich Roll?

  Mince and porridge. I eat mince and porridge.

• 1:49:07Gemma Newman?

  Yeah, so I don't eat much mince at all. I just, I tend to have like beans and lentils with my spaghetti bolognese. I like burritos, actually. I'm a big burrito fan.

• 1:49:17Rich Roll?

  You're in the right place for that.

• 1:49:17Gemma Newman?

  Yeah, I've seen, yeah, we had some amazing burritos. We went to Cafe Gratitude.

• 1:49:21Rich Roll?

  Oh, you did? I went there yesterday. Were you there?

• 1:49:24Gemma Newman?

  No, well.

• 1:49:25Rich Roll?

  Today you were there?

• 1:49:26Gemma Newman?

  Day before yesterday? Yeah, I missed you.

• 1:49:29Rich Roll?

  No, it's good there, right?

• 1:49:30Gemma Newman?

  Yeah, it's really nice.

• 1:49:31Rich Roll?

  Mm hmm.

• 1:49:32Gemma Newman?

  Yeah.

• 1:49:32Rich Roll?

  Do they have burritos in England, in the UK?

• 1:49:34Gemma Newman?

  Yeah, we do. Yeah.

• 1:49:37Rich Roll?

  And what else?

• 1:49:39Gemma Newman?

  No, that's not it. I've got lots of things I love. I love a good curry. I've got a great curry recipe in the book. Cauliflower and chickpea curry, I love. I also really like stews. And that's kind of wholesome winter. I'm thinking of all my favorite winter foods because we've had a very long winter in the UK. But now we're coming into the summer. I do love things like salads. I add in things like tempeh and tofu into my salads. And what else?

• 1:50:10Rich Roll?

  And is Richard still the cook or do you cook also?

• 1:50:13Gemma Newman?

  Yeah, I cook. Richard cooks a little bit, but so between us, we share it.

• 1:50:17Rich Roll?

  Yeah, cool. Well, let's round this out with maybe some practical guidance to kick people into this kind of lifestyle. Like when somebody comes to you and they're ready to go, like what kind of words of wisdom? Can you provide to empower them to embark upon this journey with confidence and perhaps a few practical things that they could do to make it work within the construct of their busy life?

• 1:50:43Gemma Newman?

  Well, I think the number one thing is, is think of simple swaps that you enjoy, which we've already touched on. Number two would be, again, to think about the values that are important to you. And if you could try and live by those each day, it really helps you with the food choices you're making as well as everything else. Maybe just three, just three values that would be really helpful. I don't know if you have any sort of top three that you have in your head right now?

• 1:51:09Rich Roll?

  Well, I was just thinking if I was you and I was seeing patients and I knew that they could come back and make another appointment and follow up, I would try to, because I'm competitive, I would try to find a way to gamify it. I'd say like, well, here's your numbers in these categories. I want to see them go down 10% in each, so I want you to come back in 30 days and, and we're going to do it again. So it's almost like goal oriented, like it's very practical, like here's what we're driving towards. And if you can come back, you know, every 30 days or every 60 days or something like that, and we can evaluate the progress, that creates a level of accountability and engagement.

• 1:51:47Gemma Newman?

  Yeah, I do that at work. I definitely do. And it's quite nice because you've got actual numbers to work with and you have a goal for people to have in mind. I think making, making those goals specific and time orientated really helps. So, I mean, generally for people at home, if you want to do that for yourselves, then maybe you could get your blood test done, your blood work done, and then decide, okay, in the course of four or eight weeks, I'm going to get to this number and this is how I'm going to do it. But certainly in my practice, I've found that with my patients, getting average blood sugar readings, getting cholesterol or lipid panel profile, or blood pressure readings, actually, they can change over time as well with nutrition. It's quite nice to then be able to have that accountability, to be able to bring them back

• 1:52:32Gemma Newman?

  and to encourage them as well. Yeah, I think for some of my patients, then gamifying it is good, but for others, they just tend to need that little bit of extra like compassion and care and make sure that they know that I'm going to be there and I'm going to check it again when they come back. So, yeah, it's a good strategy.

• 1:52:49Rich Roll?

  I also think being, being specific. It's fine to say it's okay to do this gradually, but how are you specifically going to accomplish that? Because to just say, "Well, I'm just gonna try and I'm gonna start eating more plants," seems very vague. But if you say, "Listen, I know you love cream in your coffee, so for the next 30 days, you're gonna do almond milk, or soy milk, or whatever it is, and you're just gonna master that one thing." Like, that's all you have to do, is like, that one thing. And it makes it very doable, because, and it's kind of like a go/no-go thing.

• 1:53:22Gemma Newman?

  Yeah.

• 1:53:23Rich Roll?

  You can wrap your head around it. This is what I'm doing. And then, after 30, 60 days of that, it's like, okay, well, that's just, I don't even think about that anymore. What's the next thing that I can do?

• 1:53:33Gemma Newman?

  Yeah, exactly.

• 1:53:34Rich Roll?

  And I think that makes it more like, because the human brain is weird, right? And if you're just like, "Well, I'm just gonna eat more plants." Like, what does that mean, right?

• 1:53:42Gemma Newman?

  Yeah.

• 1:53:42Rich Roll?

  And I think that that will wane in terms of how people are kind of consciously engaging with each meal and each food choice that they're making throughout the day.

• 1:53:52Gemma Newman?

  Yeah, you're right. And it's also so individual to people as well. So I could have one person sitting in front of me who thinks, "Okay, well, I can start with my milk." And I'll have someone else sitting in front of me that thinks, "Okay, well, I know I can just start with my breakfasts." And I'll have someone else sitting in front of me that thinks, "Okay, well, I know I can just start with two tablespoons of milled flaxseed a day." Okay, and then, so it really depends on the person, what route I go down.

• 1:54:16Rich Roll?

  Yeah.

• 1:54:16Gemma Newman?

  Based on what they feel they can achieve, based on what they already are doing, which is, yeah, is quite good to individualize it in that way, and make it really super specific.

• 1:54:24Rich Roll?

  I also think people future-trip. I'm sure they say to you, "I can't do it, because I have to go to a wedding this summer, you know, in four months," or something like that. It's like, that doesn't matter. Like, this is a sober thing. It's like, what are you doing today? Can your head hit the pillow sober tonight? That's all you have to worry about. What is your next food choice? When you, okay, you're gonna go to the grocery store today. Like, what are you gonna buy? Like, just focusing on making that next right choice, and not worrying about what you're gonna do tomorrow. Obviously, with food, there is some planning involved, like, you're getting food for the next day or for the following week. But to the extent that you can just be rooted in the moment and not freak out about, like, the rest of your life, or, "Oh, my God, I'm never gonna have this food ever again."

• 1:55:06Gemma Newman?

  It's so true.

• 1:55:07Rich Roll?

  Because I think that that really works at cross purposes with the goal.

• 1:55:10Gemma Newman?

  It's so true. That is so true. And I think about that in other aspects of life as well. You can generally manage to do something just for today. You can, you can manage to make the right kind of choice for your health and body just for today. Or you can choose not to feel angry just for today, or you can choose not to worry about something just for today.

• 1:55:35Gemma Newman?

  Yeah, and this is a slight tangent, but I actually have this daily mantra that I do, which is exactly that. It's in Japanese. And in English, it means, "Just for today, do not be angry, do not be worried, be grateful, do your duties fully, and be kind to all living things." And that is the mantra that I actually repeat to myself twice a day, every day, in Japanese, and it's just for today.

• 1:56:03Rich Roll?

  Well, you know what I'm gonna say right now. I'm gonna make you do it in Japanese.

• 1:56:08Gemma Newman?

  Okay. Oh, gosh, okay. The pressure's on. Kyodake wa ikaruna shinpaesuna kan shashtei. Kyoo hagame hitoni shinsetsuni.

• 1:56:21Rich Roll?

  That's beautiful. I think that's a good place to end it. I can't imagine a better ending than with that mantra.

• 1:56:29Gemma Newman?

  It's called the Gokai.

• 1:56:30Rich Roll?

  The Gokai? Where did you find that?

• 1:56:33Gemma Newman?

  It's part of my Jikoden Reiki practice, which is a whole other topic.

• 1:56:36Rich Roll?

  That's a whole other, yeah, that's a whole, I, I know a little bit about that, but that's a whole other podcast.

• 1:56:41Gemma Newman?

  Yeah.

• 1:56:42Rich Roll?

  Next time.

• 1:56:42Gemma Newman?

  The next time, next time. But yeah, it's a great way of living, being, thinking. You don't have to put pressure on yourself to be your best self every day. Just try and do it today.

• 1:56:55Rich Roll?

  The Plant Power Doctor paid a house call today, and I think we're all the better for it. Thank you, Gemma.

• 1:57:01Gemma Newman?

  Thank you, Rich. Thank you for all that you do.

• 1:57:03Rich Roll?

  I appreciate you. The new book is The Plant Power Doctor, available everywhere. Pick it up. It's a, it's a, it's quite an accomplishment, a beautiful book, beautiful photographs, plenty of recipes, but amazing takeaways to improve your life on the daily.

• 1:57:19Gemma Newman?

  Thank you.

• 1:57:20Rich Roll?

  I wish you well and come back and talk to me again sometime.

• 1:57:24Gemma Newman?

  I can't wait for the next time.

• 1:57:26Rich Roll?

  I gotta make it out to London.

• 1:57:27Gemma Newman?

  Yeah.

• 1:57:27Rich Roll?

  I'm trying to figure that out at some point.

• 1:57:29Gemma Newman?

  When you do, I'll be there. We'll both be there. We'll cook you amazing food. You can stay with us if you want to.

• 1:57:35Rich Roll?

  Excellent. In Buckinghamshire.

• 1:57:37Gemma Newman?

  In Buckinghamshire.

• 1:57:39Rich Roll?

  I feel like I have to see it now because in my mind, there's, you know, just, you know, beef eaters everywhere and, you know.

• 1:57:46Gemma Newman?

  No, no, it's, it's, well, Windsor, yes, we could take you to Windsor, which is only a 10 minute drive away and you'll see beef eaters everywhere there.

• 1:57:55Rich Roll?

  Good. That's a promise. And final thing, like if people want to learn more about you, what's the, where's the best place to have them go? You do a lot on Instagram.

• 1:58:05Gemma Newman?

  I do a lot on Instagram. Yeah. Plant Power Doctor on Instagram, but my website's got loads of free resources, gemmehuman.com. So yeah, check that out as well.

• 1:58:14Rich Roll?

  All right. Thanks. Peace.

• 1:58:16Gemma Newman?

  Peace and plants.

• 1:58:20Rich Roll?

  That's it for today. Thank you for listening. I truly hope you enjoyed the conversation. To learn more about today's guests, including links and resources related to everything discussed today, visit the episode page at richroll.com where you can find the entire podcast archive, as well as podcast merch, my books, Finding Ultra, Voicing Change, and The Plant Power Way, as well as the Plant Power Meal Planner at meals.richroll.com. If you'd like to support the podcast, the easiest and most impactful thing you can do is to subscribe to the show on Apple Podcasts, on Spotify, and on YouTube, and leave a review and/or comment.

• 1:59:05Rich Roll?

  Supporting the sponsors who support the show is also important and appreciated. And sharing the show or your favorite episode with friends or on social media is of course awesome and very helpful. And finally, for podcast updates, special offers on books, the meal planner, and other subjects, please subscribe to our newsletter, which you can find on the footer of any page at richroll.com. Today's show was produced and engineered by Jason Camiolo with additional audio engineering by Cale Curtis. The video edition of the podcast was created by Blake Curtis with assistance by our creative director, Dan Drake. Portraits by Davy Greenberg and Grayson Wilder.

• 1:59:46Rich Roll?

  Graphic and social media assets courtesy of Jessica Miranda, Daniel Solis, Dan Drake, and A.J. Akpodiette. Thank you Georgia Whaley for copywriting and website management. And of course, our theme music was created by Tyler Pyatt, Trapper Pyatt, and Harry Mathis. Appreciate the love, love the support. See you back here soon. Peace. Plants. Namaste. [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music] [music]